(1) Background: A traumatic birth can lead to the development of childbirth-related posttraumatic stress symptoms or disorder (CB-PTS/D). Literature has identified the risk factors for developing CB-PTS/D within the first six months postpartum thoroughly. However, the impact of mode of birth on CB-PTS/D beyond 6 months postpartum is scarcely studied. (2) Methods: A systematic search of the literature was conducted in the databases PubMed, Embase and CINAHL and PRISMA guidelines were followed. Studies were included if they reported the impact of mode of birth on CB-PTS/D beyond 6 months postpartum. (3) Results: In total, 26 quantitative and 2 qualitative studies were included. In the quantitative studies the percentage of women with CB-PTS/D ranged from 0.7% to 42% (between six months and five years postpartum). Compared with vaginal birth, operative vaginal birth, and emergency caesarean section were associated with CB-PTS/D beyond 6 months postpartum. Qualitative studies revealed that some women were suffering from CB-PTS/D as long as 18 years after birth. (4) Conclusions: Long- term screening of women for PTSD in the postnatal period could be beneficial. More research is needed on models of care that help prevent CB-PTS/D, identifying women at risk and factors that maintain CB-PTS/D beyond 6 months postpartum.

Department of General Practice and Elderly Medicine Section Midwifery Science University Medical Center Groningen University of Groningen 9700 RB Groningen The Netherlands

Department of Midwifery Science AVAG Amsterdam Public Health Research Institute Amsterdam UMC Vrije Universiteit Amsterdam 1081 BT Amsterdam The Netherlands

Department of Obstetrics and Gynaecology Maxima Medical Centre 5504 DB Veldhoven The Netherlands

Department of Psychology Faculty of Arts Charles University 116 42 Prague Czech Republic

Division of Midwifery School of Health Sciences University of Nottingham Nottingham NG7 2HA UK

School of Nursing and Midwifery Western Sydney University Penrith NSW 2751 Australia

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