Relationship between Experience of Antepartum Intervention and Posttraumatic Stress Symptoms Following Childbirth: A Prospective Study

Abstract

Background: Childbirth is an important event in a woman’s life. Adverse childbirth experiences may lead to negative psychological reactions and disturb the mother’s mental health during the postpartum period. Objective: This prospective study aimed to assess the relationship between experiences of antepartum intervention and post-traumatic stress symptoms in mothers following childbirth. Methods: The study sample comprised 176 Iranian women, who were under assessment for 8 weeks postpartum. Current Post-Traumatic Stress Disorder symptoms (PTSD) were assessed through the Impact of Events Scale-Revised (IES-R) questionnaire. Data were analyzed using SPSS software (Version 19.0), and the adjusted odds ratios (ODs) were estimated by binary logistic regression. Results: Based on the obtained results, 38.3% (N = 62) of the women appeared to be at risk of developing PTSD symptoms. The mean ± SD score of PTSD symptoms was obtained at 22.51 ± 12.04 (0-65). The results showed that women in the PTSD group underwent more obstetric interventions (P = 0.002) and experienced more childbirth pain (P = 0.048), compared to women without PTSD, during childbirth. Insertion of sublingual or vaginal prostaglandin tablets, experiencing episiotomy incision, perineal/labial/vaginal sutures, and artificial rupture of amniotic membranes correlated significantly with PTSD symptoms (P < 0.05). The results of binary logistic regression analysis confirmed that the rate of obstetric interventions was the significant predictor of PTSD after childbirth (OD = 1.284; P = 0.008). Conclusion: The findings of the present study indicate that the enhanced understanding of healthcare providers of obstetric intervention consequences may prevent postpartum PTSD through the provision of physiological delivery and supportive care during labor.