Psychologically Traumatic Birth: Associations with Increased Drinking and Delayed Risk of Alcohol Harm in Mothers

Abstract

Abstract Background Experience of trauma is a risk factor for increased alcohol use. Childbirth can be psychologically traumatic but there is minimal research investigating whether psychological birth trauma (PBT) is a risk factor for increased maternal drinking or what factors are associated with alcohol use in mothers who have and who have not experienced PBT. Method An online observational survey of mothers with (n = 291) and without (n = 230) experience of PBT. Participants self-reported alcohol use and completed measures of alcohol harm, drinking motives, trauma (general and birth related) and mental health. Free text options were included to complement quantitative data. Results Irrespective of PBT status, stronger endorsement of negative reinforcement drinking motives (e.g. coping) predicted higher alcohol use and hazardous drinking. However, children’s age influenced this relationship. In mothers with a history of PBT, negative reinforcement drinking motives predicted weekly alcohol use and alcohol harm as their children grew older. In mothers without PBT, positive reinforcement drinking motives predicted greater weekly alcohol use as children grew older, but negative drinking motives predicted reduced drinking. Multiple aspects of the parental role influenced drinking (e.g. coping-based motives) and non-drinking (e.g. child well-being motives) behaviour. Changes in motives from pre-motherhood to motherhood focused around a shift from positive to negative reinforcement drinking motives. Mothers with PBT reported mental health symptoms as both a reason to drink and not to drink alcohol. Conclusion This study provides novel evidence on maternal alcohol use, and how PBT may influence drinking behaviour in mothers. Importantly, PBT may be a type of trauma which is associated with a delayed risk for maladaptive alcohol use and risk of alcohol harm. This evidence can facilitate more research aimed at understanding this important public health issue and can inform alcohol interventions tailored to the needs of mothers which consider the long-lasting impact of birth experience.