Rates of PTSD are higher in pregnant women than non-pregnant women. Beck (2011), found in a nationwide study of 1,373 postpartum women that 9% met diagnostic criteria for PTSD while 18% had significantly elevated symptoms. The unique psychological and physical aspects of pregnancy may exacerbate PTSD. For women who have PTSD related to childhood abuse, preparing to become a parent can carry complex feelings and worsen anxiety. Physical changes during pregnancy or prenatal care could trigger symptoms in women with a history of sexual abuse. Seng investigated perinatal outcomes for 839 women with and without PTSD. infants born to mothers with PTSD had a lower mean birth weight than infants in the trauma-exposed group without PTSD or the group without a trauma history. Additionally, Smith(2006), found that women with active PTSD symptoms in pregnancy were more likely to engage in poor health behaviors, including substance use, which may impact infant outcomes.