Abstract
Research suggests that some fathers and birth partners can experience post-traumatic stress disorder (PTSD) after witnessing a traumatic birth. Birth-related PTSD may impact on many aspects of fathers’ and birth partners’ life, including relationship breakdown, self-blame and reducing plans for future children. Despite the potential impact on birth partners’ lives there is currently no measure of birth-related PTSD validated for use with birth partners. The current study therefore adapted the City Birth Trauma Scale for use with birth partners. The City Birth Trauma Scale (Partner version) is a 29-item questionnaire developed to measure birth-related PTSD according to DSM-5 criteria: stressor criteria (A), symptoms of re-experiencing (B), avoidance (C), negative cognitions and mood (D), and hyperarousal (E), as well as duration of symptoms (F), significant distress or impairment (G), and exclusion criteria or other causes (H). A sample of 301 fathers/birth partners was recruited online and completed measures of birth-related PTSD, bonding, and demographic details. Results showed the City Birth Trauma Scale (Partner version) had good reliability (α = 0.94) and psychometric and construct validity. The fathers/birth partners version has the same two-factor structure as the original scale: (1) general symptoms and (2) birth-related symptoms, which accounted for 51% of the variance. PTSD symptoms were associated with preterm birth and maternal and infant complications. Overall, the City Birth Trauma Scale (Partner version) provides a promising measure of PTSD following childbirth that can be used in research and clinical practice.
Highlights
Post-traumatic stress disorder (PTSD) is a trauma and stressor-related disorder that may develop following direct or indirect exposure to, or witnessing of, actual or threatened death, serious injury or sexual violence (American Psychiatric Association, 2014)
Fathers/birth partners included in the final sample (n = 301) ranged in age from 21 to 60 years (M = 34.59; SD = 6.08)
The aim of this paper was to adapt the City BiTS to create a version for fathers and birth partners and test the reliability and psychometric validity in a sample of fathers/birth partners
Summary
Post-traumatic stress disorder (PTSD) is a trauma and stressor-related disorder that may develop following direct or indirect exposure to, or witnessing of, actual or threatened death, serious injury or sexual violence (American Psychiatric Association, 2014). A meta-synthesis of the experience of birth partners found that some (both male and female) were deeply affected by witnessing a woman’s pain during labor, such as through feelings of frustration, fear, and helplessness (Bohren et al, 2019). This suggests being a birth partner may increase the risk of developing PTSD. Research suggests that men do not always ask for support and there is a lack of recognition or comprehension regarding the issue by healthcare professionals (Hinton et al, 2014; Poh et al, 2014; White, 2014; Elmir and Schmied, 2016) These factors may lead to the psychological needs of fathers/birth partners not being recognized and subsequently fathers/birth partners not being provided with appropriate support or treatment. Case studies and qualitative research suggests some men may continue for years without seeking professional support for the effects of birth trauma (Beck et al, 2013; Hinton et al, 2014; White, 2014)
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