ORIGINAL CONTRIBUTION PTSD and postpartum mental health in a sample of Caucasian, Asian, and Pacific Islander women Jane M. Onoye & Deborah Goebert & Leslie Morland & Courtenay Matsu & Tricia Wright Received: 6 February 2009 / Accepted: 12 June 2009 / Published online: 30 June 2009 # Springer-Verlag 2009 Abstract To better understand the role of posttraumatic stress disorder (PTSD) in postpartum health, this study investigates the relationship of PTSD and associated perinatal behavioral risk factors in a sample of Caucasian, Asian, and Pacific Islander women. As part of a larger longitudinal study, 54 women (18–35 years of age) were interviewed at their postpartum clinic visit for PTSD, anxiety, depression, and alcohol and substance use. PTSD and subclinical PTSD during the postpartum period were associated with behavioral health risks, with PTSD at the onset of pregnancy being a predictor of postpartum PTSD by a factor of three. Women with PTSD and subclinical PTSD were more likely to also experience stress (73%), anxiety (64%), and depression (73%) during the postpartum period compared to those without PTSD. No significant differences were found by ethnicity for postpartum PTSD, depression, or anxiety. Regardless of ethnicity or PTSD status, one in four women in the sample had a probable mental health disorder or risk behavior of some type during the postpartum period. Given the rates of associated mental health risks with PTSD, these findings suggest further research examining the fluctuations of PTSD symptomatol- ogy throughout each pregnancy trimester to determine its role as a potential mediator during the perinatal period. Further research is also needed to elucidate the role of ethnic or cultural differences in trauma and PTSD and perinatal health. Keywords Postpartum . Subclinical . PTSD . Mental health . Ethnicity Introduction Relatively little attention has been given to the perinatal period in terms of risk for different kinds of mental disorders and describing risk factors from physical, psy- chological, and social stresses. Although disorders such as postpartum depression have gained greater attention as perinatal mental health issues (Brockington 2004; Dossett 2008; Wisner et al. 2006), less is known about the behavioral health risk factors associated with posttraumatic stress disorder (PTSD) and traumatic stress which are also likely to have an impact on postpartum health. PTSD has been linked to variety of behavioral health risk factors such as substance abuse and poor health care (Breslau et al. 1991; Schnurr and Jankowski 1999), which in turn, can impact perinatal health and potentially link to adverse birth outcomes such as preterm delivery, babies that are small or large for gestational age, or other complications (Born et al. 2006; Randall 2001; Rogal et al. 2007; Rosen et al. 2007; Russell and Skinner 1988; Seng et al. 2008). However, the relationship between PTSD and behavioral health during pregnancy and the postpartum period has not been fully explored. PTSD has gained increasing attention as a widespread problem, however the potential implications for women’ s mental and reproductive health have not been significantly addressed. Women are twice as likely to develop PTSD following a traumatic event compared to men (Kessler et al. 1995), with traumatic experiences often occurring prior to or during childbearing years (Breslau et al. 1991). PTSD prevalence rates are estimated to range from 9.7% to 12.3% for women having PTSD in their lifetime, and 4.6% to 5.2% of women with current PTSD (Kessler et al. 2005; Resnick et al. 1993). Further, women are exposed to interpersonal trauma (e.g., abuse or assault) at under- Arch Womens Ment Health (2009) 12:393–400 DOI 10.1007/s00737-009-0087-0 J. M. Onoye (*) : D. Goebert : L. Morland : C. Matsu : T. Wright University of Hawai’i at Mānoa, Honolulu, HI, USA e-mail: onoyej@dop.hawaii.edu