Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Cynthia D. Connelly, PhD, RN, FAAN, Chairperson; Ruth A. Bush, PhD, MPH; Jane M. Georges, PhD, RN


concept analysis, Integrated Perinatal Health Framework, perinatal, posttraumatic stress disorder, post traumatic stress disorder, PTSD


Improving maternal mental health is a global public health priority (World Health Organization [WHO], 2014). Notably, impaired maternal mental health can lead to complex health complications for both the mother and the developing fetus. In the United States, it is estimated between 15 and 29% of women will experience an undiagnosed mental health disorder during pregnancy and postpartum due to social stigmas preventing treatment, multifaceted health disparities preventing healthcare access, and healthcare systems insufficiencies hindering current treatment. Within the health research and policy priority of maternal and child health, knowledge of factors that affect the most vulnerable women and their children is needed. One mental health disorder, posttraumatic stress disorder (PTSD), is rising in U.S. prevalence. In the literature, there is limited knowledge about the defining factors of Perinatal Posttraumatic Stress Disorder (PPTSD), its comorbidities and outcomes. Given the dynamic and multifaceted relationship between PPTSD and perinatal depression, further studies need to explore these issues especially in underserved and vulnerable populations. Therefore, three aims were developed and met through a concept analysis and data collection guided by the Integrated Perinatal Health Framework. This work clarifies the disorder of PPTSD, and examines relationships between PPTSD, perinatal depression, and the adverse maternal child outcomes. This work is presented in three manuscripts.

The first manuscript “Posttraumatic Stress Disorder in the Perinatal Period: A Concept Analysis” fully explores the phenomenon of PPTSD through clarifying its definition, antecedents, and consequences that differentiate the phenomena from classic PTSD in adults. The second manuscript “Perinatal Depression and Risk Factors of Perinatal Posttraumatic Stress Disorder” identifies risk factors of PPTSD among economically, educationally, and ethnically / racially diverse women with depression. The third manuscript “Perinatal Depression, Perinatal Posttraumatic Stress Disorder, and Adverse Infant Outcomes” examines the adverse infant outcomes of mothers with depressive and posttraumatic stress disorder symptoms in an economically, educationally, and racially/ethnically diverse perinatal population. Ultimately research clarifications will contribute to nursing science in order to improve patient outcomes, decrease healthcare costs, and ultimately improve maternal child outcomes.

Document Type

Dissertation: USD Users Only