Traumatic birth ranged from 7% to 69% across 31 countries in one survey

Around 140 million births occur worldwide each year, and for some women the experience is traumatic enough to produce childbirth-related post-traumatic stress disorder, with consequences for the woman and her family [s1]. How often that happens has been estimated many times in single countries and almost never in a way that allows those estimates to be compared. The INTERSECT study, published in The British Journal of Psychiatry on 28 August, is an attempt at a comparable measurement across 31 countries at once [s1].

What was measured

INTERSECT — the International Survey of Childbirth-Related Trauma — was a cross-sectional survey conducted in 31 countries [s1]. Women were eligible if they were 6 to 12 weeks postpartum, legal adults, and gave informed consent; recruitment ran through routine maternity services and data were collected from April 2021 to January 2024 [s1].

Outcomes were assessed with the City Birth Trauma Scale [s1]. Traumatic birth was coded using DSM-5 criteria for a traumatic stressor, and childbirth-related PTSD was classified when all PTSD criteria were met; the dissociative subtype and differential diagnoses were also assessed [s1].

A total of 11,302 women took part [s1]. Most were married, aged 30 to 34, with average household income and higher education, and 9.7% identified as being from ethnic or racial minority groups [s1].

The numbers

Traumatic birth ranged from 7% to 69% across countries, with a mean of 23.3% (95% CI, 22.4–24.0) [s1]. Childbirth-related PTSD ranged from 1% to 36%, mean 6.7% (95% CI, 3.7–9.7) [s1].

Subtypes varied similarly. The dissociative subtype ranged from 1% to 24% (mean 3.8%; 95% CI, 2.1–5.4) and acute childbirth-related PTSD from 0% to 7% (mean 1.3%; 95% CI, 0.7–1.9) [s1]. Removing participants with potential differential diagnoses did not change prevalence rates in most countries [s1].

The authors also record something the diagnostic thresholds miss: many participants reported distress and impairment from symptoms even when they did not meet the criteria for childbirth-related PTSD [s1].

Why the range is the result

A mean of 6.7% is the number that will be quoted. It is the least informative figure in the paper.

The confidence interval around it — 3.7% to 9.7% [s1] — is wide because the underlying country-level estimates span a 36-fold range. Averaging a 1% country and a 36% country produces a number that describes neither. The authors' own interpretation is that the wide variation suggests cultural and healthcare factors unique to each country are important [s1].

That interpretation is the reasonable one, and it should be held alongside a measurement caution. The City Birth Trauma Scale is a self-report instrument administered here in 31 national contexts; some of the variation between countries will reflect real differences in obstetric practice and some will reflect differences in how the same items are understood and answered. A survey design cannot separate those two.

The sample composition compounds it. Participants were recruited through routine maternity services and skewed married, higher-educated and around average household income [s1]. Women outside routine maternity care — a group whose birth experiences are plausibly worse in most health systems — are structurally under-represented in a design like this one.

What follows from it

The authors conclude that a notable proportion of women experience traumatic birth and childbirth-related PTSD, and that the findings emphasise routine trauma-informed assessment and culturally informed support in perinatal mental healthcare [s1].

The evidence on what to offer after such an assessment is more developed than the prevalence literature. A 2025 network meta-analysis of 42 randomised trials covering 18 distinct intervention types sorted them into three prevention levels: primary prevention during pregnancy (5 trials), secondary prevention after a traumatic birth (26 trials), and tertiary prevention for women already diagnosed (11 trials) [s2].

Its findings are specific enough to be useful and preliminary enough to require care. In primary prevention, a birth plan intervention was most effective at reducing childbirth-related PTSD symptom scores against conventional postpartum care, while nurse-led peer support was most effective for depression scores [s2]. In secondary prevention, a couples' self-disclosure intervention showed superior efficacy for PTSD symptoms and counselling was most effective for depression and anxiety [s2]. At the tertiary stage, counselling was most effective for PTSD symptoms and expressive writing for depression and anxiety [s2].

Network meta-analyses rank interventions largely through indirect comparison, and a ranking built from 42 heterogeneous trials across 18 intervention types is a research agenda rather than a protocol. But it establishes the more important prior: this is a condition with tested non-pharmacological options, which makes the case for measuring it properly stronger, not weaker.

Sources

• [s1] "International prevalence of childbirth-related post-traumatic stress disorder: INTERSECT study," The British Journal of Psychiatry, 28 August 2026. https://doi.org/10.1192/bjp.2026.10708
• [s2] "Nonpharmacological interventions for childbirth-related post-traumatic stress disorder and accompanying symptoms: A network meta-analysis of randomized controlled trials," International Journal of Nursing Studies, 9 August 2025. https://doi.org/10.1016/j.ijnurstu.2025.105186