Postpartum Posttraumatic Stress Disorder Research Articles

A two-item screening of maternal or infant perceived life threat during childbirth prospectively associated with childbirth-related posttraumatic stress symptoms up to six months postpartum: two observational longitudinal studies.

This study investigated prospective relationships between the perception of threat to one's own life or to that of one's infant during childbirth and maternal childbirth-related posttraumatic stress symptoms (CB-PTSS) and probable childbirth-related posttraumatic stress disorder (CB-PTSD) in a community and a community and an emergency cesarean section (ECS) sample. Study samples included 72 mothers from a community sample and 75 mothers after emergency cesarean section. Perceived maternal and infant life threat were assessed at ≤1 week postpartum. Maternal CB-PTSS and probable CB-PTSD were assessed with validated questionnaires up to 6 months postpartum. Covariates were extracted from hospital records. Secondary data analysis with logistic and linear regressions was performed. Globally, mothers were significantly more likely to perceive their infant's life to be threatened, rather than their own. Both types of perceived threat were prospectively but differentially associated with maternal CB-PTSS and probable CB-PTSD at 4-6 weeks and 6 months postpartum. Statistical significance was set at p<0.05. The type of perceived threat differently influences maternal CB-PTSS and probable CB-PTSD up to 6 months postpartum. These results may be the basis for the development of a short screening instrument after traumatic childbirth in clinical settings. Future studies need to assess the psychometric properties and acceptability of such a brief screening tool.

Psychological Outcomes Associated with Severe Placenta Accreta Spectrum Disorder with Cesarean Hysterectomy: A Retrospective Survey Study

This retrospective survey study assesses rates of postpartum depression (PPD) and postpartum post-traumatic stress disorder (PTSD) in patients with prior hysterectomy for severe placenta accreta spectrum. 50% of patients met the Edinburgh Postnatal Depression Scale threshold for PPD, and 35% met the Post-traumatic Stress Disorder Checklist-5 (PCL-5) threshold for PTSD. Patients who underwent a delayed hysterectomy were more likely to report symptoms of PTSD (75% vs. 8%, p&lt;0.01) and had higher median PCL-5 scores than an immediate hysterectomy (51 [IQR 16,61]) vs. 11 [IQR 2,21], p=0.01). Larger, prospective studies are needed to confirm these findings and determine standardized interventions for patients at high risk of psychological sequelae.

Are 6 more accurate than 4? The influence of different modes of delivery on postpartum depression and PTSD

BackgroundEmpirical evidence shows that 4.6–6.3% of all women develop a post-traumatic stress disorder (PTSD) and approximately 10–15% postpartum depression (PPD) following childbirth. This study explores the relationship between delivery mode and the occurrence of PTSD and PPD, specifically examining four distinct caesarean section (CS) modes: primary on maternal request (Grade 4), medically indicated primary (Grade 3), secondary CS from relative indication (Grade 2) and emergency secondary CS (Grade 1), compared to vaginal and assisted vaginal delivery (AVD). The research aims to understand how these six subcategories of delivery modes impact PPD and PTSD levels. Common predictors, including the need for psychological treatment before childbirth, fear of childbirth, planning of pregnancy, induction of labor, birth debriefing, and lack of social support after childbirth, will be analyzed to determine their association with postpartum mental health outcomes.MethodsThe study was planned and carried out by a research team of the psychology department at the Medical School Hamburg, Germany. Within an online-study (cross-sectional design) N = 1223 German speaking women with a baby who did not die before, during or after birth were surveyed once between four weeks and twelve months postpartum via an anonymous online questionnaire on demographic and gynecological data, delivery mode, PTSD (PCL-5) and PPD (EPDS).ResultsFor both psychiatric disorders, ANOVA revealed significant differences between delivery mode and PPD and PTSD. With weak effects for PPD and medium to strong effects for PTSD. Post-hoc tests showed increased levels of PPD for two CS types (Grade 1, Grade 3) compared to vaginal delivery. For PTSD, secondary CS from relative indication (Grade 2), emergency secondary CS (Grade 1) and assisted vaginal delivery (AVD) were associated with elevated levels of PTSD. Regression analysis revealed delivery mode as a significant predictor of EPDS- (medium effect size) and PCL-5-Score (medium to high effect size).LimitationDelivery was considered as the potential traumatic event, and any previous traumas were not documented. Additionally, the categorization of delivery modes relied on subjective reports rather than medical confirmation.ConclusionThe study highlights the influence of delivery mode on the mental health of postpartum mothers: different modes influence postpartum disorders in various ways. However, the definition of delivery mode was only stated subjectively and not medically confirmed. Further research should investigate which aspects of the different delivery modes affect maternal mental health and explore how the perception of childbirth may be influenced by specific delivery experiences.

Associations Between Child Maltreatment Types and Pre- and Post-Partum Posttraumatic Stress Disorder Symptoms: A Brief Report

Objective: To foster resilience through reducing posttraumatic stress disorder (PTSD) symptoms in pregnant mothers with child maltreatment (CM) histories, it is important to understand factors impacting their well-being. This study explored whether CM predicted the severity of PTSD symptoms and symptom clusters during pregnancy and change in symptoms from pregnancy (Time 1; T1) to 3 months postpartum (Time 2; T2).&#x0D; Methods: 88 pregnant women (aged 18 to 29) completed surveys on CM exposure, adult interpersonal trauma experiences, and PTSD symptoms at T1; 58 participated at T2.&#x0D; Results: Stepwise regressions were conducted with the covariates age, family status, and adult interpersonal traumas. When accounting for all CM types, only neglect remained associated with overall PTSD symptoms (Ft1(1, 71) = 28.93, p &lt; .001) and for each of the PTSD symptom clusters (ps &lt; .01). Physical abuse remained associated with the alterations in cognition and mood cluster. No CM types were associated with changes in PTSD symptoms from T1 to T2.&#x0D; Implications: In future research, the implications of neglect for pregnant mothers should be explored in depth. Perinatal care should be trauma-informed, including assessing for CM histories, to foster greater resilience by reducing perinatal PTSD symptoms.

Risk factors for postpartum posttraumatic stress disorder after emergency admission.

Postpartum posttraumatic stress disorder (PTSD) can occur in women who give birth after emergency admission. The identification of risk factors for this condition is crucial for developing effective preventive measures. This retrospective study aimed to explore the incidence and risk factors for postpartum PTSD in women who give birth after emergency admission. Medical records of women who gave birth after emergency admission were collected between March 2021 and April 2023. The patients' general conditions and perinatal clinical indicators were recorded. The puerperae were divided into PTSD group and control group based on symptom occurrence at six weeks postpartum. Multivariate logistic regression analysis was performed to identify risk factors. A total of 276 puerperae were included, with a PTSD incidence of 20.3% at six weeks postpartum. Multivariate logistic regression analysis identified emergency cesarean section (odds ratio [OR]=2.102; 95% confidence interval [CI]: 1.114-3.966, P=0.022), admission to the emergency department after midnight (12:00 AM) (OR=2.245; 95%CI: 1.170-4.305, P<0.001), and cervical dilation (OR=3.203; 95%CI: 1.670-6.141, P=0.039) as independent risk factors for postpartum PTSD. Analgesia pump use (OR= 0.500; 95%CI: 0.259-0.966, P=0.015) was found to be a protective factor against postpartum PTSD. Emergency cesarean section, admission to the emergency department after midnight, and cervical dilation were identified as independent risk factors for postpartum PTSD, while analgesic pump use was a protective factor. These findings provide insights for developing more effective preventive measures for women who give birth after emergency admission.

Swiss cohort on Traumatic Childbirth and Health (SwiTCH): protocol for a prospective, population-based cohort study on parents’ mental health from pregnancy to one year postpartum

IntroductionApproximately 4%–5% of mothers develop childbirth-related post-traumatic stress disorder (CB-PTSD) and approximately 12.3% of mothers develop some CB-PTSD symptoms (CB-PTSS). To date, there is a dearth of studies on fathers...

Traumatic birth and childbirth-related post-traumatic stress disorder: International expert consensus recommendations for practice, policy, and research

BackgroundResearch suggests 1 in 3 births are experienced as psychologically traumatic and about 4% of women and 1% of their partners develop post-traumatic stress disorder (PTSD) as a result. AimTo provide expert consensus recommendations for practice, policy, and research and theory. MethodTwo consultations (n = 65 and n = 43) with an international group of expert researchers and clinicians from 33 countries involved in COST Action CA18211; three meetings with CA18211 group leaders and stakeholders; followed by review and feedback from people with lived experience and CA18211 members (n = 238). FindingsRecommendations for practice include that care for women and birth partners must be given in ways that minimise negative birth experiences. This includes respecting women’s rights before, during, and after childbirth; and preventing maltreatment and obstetric violence. Principles of trauma-informed care need to be integrated across maternity settings. Recommendations for policy include that national and international guidelines are needed to increase awareness of perinatal mental health problems, including traumatic birth and childbirth-related PTSD, and outline evidence-based, practical strategies for detection, prevention, and treatment. Recommendations for research and theory include that birth needs to be understood through a neuro-biopsychosocial framework. Longitudinal studies with representative and global samples are warranted; and research on prevention, intervention and cost to society is essential. ConclusionImplementation of these recommendations could potentially reduce traumatic births and childbirth-related PTSD worldwide and improve outcomes for women and families. Recommendations should ideally be incorporated into a comprehensive, holistic approach to mental health support for all involved in the childbirth process.

Post-traumatic stress disorder following childbirth: a neglected cause.

Post-traumatic stress disorder (PTSD) following childbirth is a significant mental health risk for women globally. However, it remains a neglected cause, particularly in low-income countries like Pakistan. This paper explores the unique challenges faced by women in such settings, including limited access to healthcare and social support, cultural norms, and stigma surrounding mental health. The diagnosis and causes of postpartum PTSD are discussed, along with its effects on both mothers and their infants. The lack of awareness and training among healthcare professionals in recognizing and treating postpartum PTSD is highlighted as a major barrier to adequate care. To address these challenges, the paper proposes a comprehensive approach, including raising public awareness, providing mental health support and resources, and integrating postpartum mental health into medical education. Trauma-focused therapies are recommended for effective treatment. The paper concludes with the need for more research in low-income countries and emphasizes the importance of understanding and supporting women with postpartum PTSD to improve their well-being and maternal and child health.

Establishing the validity of a diagnostic questionnaire for childbirth-related posttraumatic stress disorder

Labor and delivery can entail complications and severe maternal morbidities that threaten a woman's life or cause her to believe that her life is in danger. Women with these experiences are at risk for developing post-traumatic stress disorder (PTSD). Postpartum PTSD, or childbirth-related PTSD, can become an enduring and debilitating condition. At present, validated tools for a rapid and efficient screen for childbirth-related PTSD are lacking. We examined the diagnostic validity of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 (PCL-5) for detecting PTSD in women who have had a traumatic childbirth. The PCL-5 assesses the 20 DSM-5 PTSD symptoms and is a commonly used patient-administrated screening instrument. Its diagnostic accuracy in regard to childbirth-related PTSD is unknown. The sample included 59 patients who reported a traumatic childbirth experience. A traumatic childbirth was determined in accordance with the DSM-5 PTSD Criterion A for exposure involving threat or potential threat to the life of the mother or infant, experienced or perceived, or physical injury. The majority (66%) were less than 1 year postpartum (for full sample: median = 4.67 months; mean = 1.5 years) recruited via Mass General Brigham's online platform or during postpartum unit hospitalization/ after discharge. Patients were instructed to complete the PCL-5 concerning PTSD symptoms related to childbirth. Other co-morbid conditions (i.e., depression and anxiety) were also assessed. They also underwent a clinician interview for PTSD using the gold-standard, Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). A second administration of the Checklist was performed in a sub-group (n = 43), altogether allowing for an assessment of internal consistency, test-retest reliability, and convergent and diagnostic validity of the PCL-5. Diagnostic accuracy of the PCL-5 in reference to the CAPS-5 was determined using the Receiver Operating Characteristic (ROC) area under curve (AUC); an optimal cutoff score was identified with Youden's J index. One-third of the sample (35.59%) met DSM-5 criteria for a PTSD diagnosis stemming from childbirth. The PCL-5 symptom severity score was strongly correlated with the CAPS-5 total score (ρ = 0.82, p < 0.001). The AUC was 0.93 (95% CI: 0.87-0.99), indicating excellent diagnostic performance of the PCL-5. A cutoff value of 28 maximized sensitivity (0.81) and specificity (0.90), and correctly diagnosed 86.44% of women. A higher value (32) identified individuals with more severe PTSD symptoms (specificity, 0.95), but with lower sensitivity (0.62). PCL-5 scores were stable over time (intraclass correlation coefficient, ICC = 0.73), indicating good test-retest reliability. PCL-5 scores were moderately correlated with depression and anxiety symptom scores (Edinburgh Postnatal Depression Scale, EPDS, ρ = 0.58, p < 0.001) and Brief Symptom Inventory (BSI, anxiety sub-scale, ρ = 0.51, p < 0.001). This study demonstrates the validity of the PCL-5 as a screen for PTSD among women who had a traumatic childbirth experience. The instrument may facilitate screening for childbirth-related PTSD on a large scale and help to identify women who might benefit from further diagnostics and services. Replication of findings in large postpartum samples is needed.

Childbirth-related posttraumatic stress symptoms – examining associations with hair endocannabinoid concentrations during pregnancy and lifetime trauma

Evidence has linked alterations of the endocannabinoid system with trauma exposure and posttraumatic stress disorder (PTSD). Childbirth-related PTSD symptoms (CB-PTSS) affect about every eighth woman and can negatively influence the entire family. While aetiological models of CB-PTSD include psychological risk factors such as maternal trauma history and negative subjective birth experience (SBE), they lack biological risk indicators. We investigated whether lifetime trauma and CB-PTSS were associated with long-term endocannabinoid concentrations during pregnancy. Further, we tested endocannabinoids as mediators between lifetime trauma and CB-PTSS and whether SBE moderated such mediational paths. Within the prospective cohort study DREAMHAIR, 263 expectant mothers completed trauma assessments and provided hair samples for quantification of long-term endocannabinoid levels (anandamide [AEA], 2-arachidonoylglycerol [1-AG/2-AG], and N-acyl-ethanolamides [NAE]) prior to their anticipated birth date. Two months postpartum, CB-PTSS and SBE were measured. Regression models controlling for relevant confounders showed no association between lifetime trauma and hair endocannabinoids during pregnancy, yet higher number of lifetime trauma events and lower hair AEA were significantly associated with CB-PTSS, with the latter finding not remaining significant when Bonferroni corrections due to multiple testing were applied. While hair AEA did not mediate the association between lifetime trauma and CB-PTSS, the effect of lower hair AEA on CB-PTSS was stronger upon negative SBE. Results suggest greater lifetime trauma and reduced maternal hair AEA during pregnancy may be associated with increased risk for CB-PTSS, particularly upon negative SBE. Findings confirm lifetime trauma as a CB-PTSS risk factor and add important preliminary insights on the role of endocannabinoid ligand alterations and SBE in CB-PTSS pathology.

A Thematic Analysis of Narratives About Birth Satisfaction and Health Awareness From Postnatal Women Who Have High and Low Trauma Scores on thePosttraumatic Stress Disorder Checklist

BACKGROUND:Around one-third of women experience childbirth trauma, with 3%–15% developing postpartum posttraumatic stress disorder (PP-PTSD).AIM:Explore birth satisfaction and health perception across two groups of postnatal women with either high or low trauma scores.METHOD:Forty postnatal women were divided into groups dependent upon Posttraumatic Stress Disorder Checklist (PCL-5) scores: high severity (n= 20; range 25–57) or low severity (n= 20; range 0–7). Semi-structured interviews explored women’s childbirth experiences related to birth satisfaction and reports of postnatal health. Thematic analysis was performed.FINDINGS:Narrative content differed appreciably between high (A) and low (B) scoring groups. Group A narratives were more negative (A1: Overall, a negative recall), referencing lack of autonomy, support, or being heard (A2: Missing needs) and negative influences (A3: Disrupting my bubble). Group B recalled more birth satisfaction (B1: Mostly positive recall) associated with (B2: Autonomy; B3: Being cared for; B4: Intuition, instinct, and primal force). Group A narratives focused strongly on mental health (A4: Reduced awareness; A6: Experiencing PTSD; A7: Needing help), with some focus on physical health (A5: How I feel physically); Group B spoke less about health (B5: My health).DISCUSSION:High-quality psychological care during labor, with continuity, choice, support, and control, alongside postnatal health follow-up may improve birth satisfaction and reduce the incidence of PP-PTSD.CONCLUSION:To increase birth satisfaction and reduce trauma, maternity care providers must be supported to prioritize high-quality psychological care to women during labor, providing choice, control, and continuity within trusting relationships. Trusting relationships are key to ongoing conversations regarding health and seeking/receiving help. Routine birth satisfaction screening and education for care providers about signs of trauma are important.

Peripartum dissociation, sense of control, postpartum posttraumatic stress disorder and emotional adjustment to motherhood in adult survivors of childhood maltreatment.

Survivors of childhood maltreatment (CM) may experience difficulties in the peripartum period and in adjustment to motherhood. In this study we examined a model wherein CM is associated with maternal self-efficacy and maternal bonding three months postpartum, through mediation of peripartum dissociation and reduced sense of control during childbirth and postpartum-posttraumatic-stress disorder (P-PTSD). Women were recruited in a maternity ward within 48h of childbirth (T1, N = 440), and contacted three-months postpartum (T2, N = 295). Participants completed self-report questionnaires: peripartum dissociation, sense of control (T1), and CM, P-PTSD, postpartum-depression, maternal self-efficacy and bonding (T2). Obstetrical data were collected from medical files. Structural equation modeling was conducted to test the hypothesized model, controlling for mode of delivery and postpartum-depression. Reported CM included child emotional neglect (CEN; 23.5%), child emotional abuse (CEA; 16.3%), child sexual abuse (CSA; 12.9%) and child physical abuse (CPA; 7.1%). CM was positively associated with peripartum dissociation and P-PTSD (p < .001). Peripartum dissociation was positively associated with P-PTSD (p < .001). P-PTSD was negatively associated with maternal self-efficacy (p < .001) and maternal bonding (p < .001). Association between CM and maternal self-efficacy and bonding was serially mediated by peripartum dissociation and P-PTSD, but not by sense of control. Findings remained significant after controlling for mode of delivery and postpartum-depression. CM is a risk factor for adjustment to motherhood, owing to its effects on peripartum dissociation and P-PTSD. Implementation of a trauma-informed approach in obstetric care and recognition of peripartum dissociative reactions are warranted.

Assessment of maternal posttraumatic stress disorder following childbirth: Psychometric properties of the Swedish version of City Birth Trauma Scale.

City Birth Trauma Scale (City BiTS) is an instrument designed to evaluate and diagnose postpartum posttraumatic stress disorder (PTSD) according to the 5th edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5). No validated Swedish instrument exists to measure postpartum PTSD according to DSM-5. Therefore, the primary aim of this study was to assess the psychometric properties of the Swedish version of the City BiTS (City BiTS-Swe) and to examine the latent factor structure of postpartum PTSD. The secondary aim was to report the Swedish prevalence of PTSD following childbirth. A total of 619 women, who had given birth at five clinics in the past 6-16 weeks, completed an online version of City BiTS-Swe and the Edinburgh Postnatal Depression Scale (EPDS). Additionally, sociodemographic and medical data were collected. A second questionnaire was answered by 110 women to examine reliability over time. The confirmatory factor analysis using the two-factor model gave best fit to the data. We found a high internal consistency (α = .89-.87) and good test-retest reliability (ICC = 0.53-0.90). Divergent reliability with EPDS showed significant correlations with satisfying results for the subscale birth-related symptoms (r = .41). We also found discriminant validity concerning mode of birth, parity, gestational age, mental illness, history of traumatic childbirth, and history of traumatic event as expected. The prevalence of PTSD was 3.8%. The City BiTS-Swe is a valid and reliable instrument to assess and diagnose PTSD following childbirth. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The latent factor structure and assessment of childbirth-related PTSD in fathers: Psychometric characteristics of the City Birth Trauma Scale-French version (partner version).

There is no evidence on the latent structure of symptoms of childbirth-related posttraumatic stress disorder (CB-PTSD) in fathers and to date, no validated French instrument exists to measure CB-PTSD in partners, although the City Birth Trauma Scale (partner version) (City BiTS (P)) was developed to measure such CB-PTSD symptoms. This study aimed to validate the French version of the City BiTS-P (City BiTS-F (P)) in partners attending childbirth and to examine its factor structure, reliability, and validity. French-speaking fathers of 1-to-12-month-olds participated in this online cross-sectional survey (n = 280). They completed the City BiTS-F (P), the PTSD Checklist, the Edinburgh Postnatal Depression Scale, and the anxiety subscale of the Hospital Anxiety and Depression Scale, as well as sociodemographic and medical items. The four-factor model did not fit well the data, contrary to the two-factor model with birth-related symptoms (BRS) and general symptoms (GS). However, the bifactor model with a general factor and the BRS and GS provided the best fit to the data. High reliability (α = .88-.89), and good convergent and divergent validity were found. Fathers with a history of traumatic childbirth reported higher total and subscale scores. Our findings provide evidence for the use of the City BiTS-F (P) as a reliable and validated tool to assess CB-PTSD symptoms in French-speaking partners. The use of the total score in addition to the BRS and GS subscale scores is warranted. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Korean women’s perceptions of traumatic childbirth: a qualitative descriptive study

BackgroundPrevious studies have established that negative or traumatic childbirth can create childbirth-related post-traumatic stress disorder (CB-PTSD). Because of the negative implications of CB-PTSD for mothers, children, and families, global qualitative research on traumatic or negative childbirth has risen in recent years. However, few studies have been conducted in South Korea. This study aims to explore women’s various perceptions of traumatic childbirth in South Korea.MethodsThis qualitative descriptive study examined nine women who were at high risk of PTSD (IES-R-K > 24) at the time of the interview, between 1 and 11 years after childbirth. Semi-structured interviews were conducted. Interview transcripts were subjected to thematic analysis.ResultsThe analysis identified two themes with six subthemes, as follows: (1) person-centred factors (pain, guilt, maternal identity conflict, and damaged femininity); (2) society-centred factors (threatened dignity and disrupted relationships). These findings may be attributed to Korean culture (excessive motherhood and lookism), as well as unbearable pain, disrespectful childbirth environments, lack of spouse’s support, loss of their lifestyle, and unrealistic expectations.ConclusionsThis study demonstrates various negative consequences, ranging from psychological damage to conflict in women’s relationships with their spouses, and others. This highlights the various perceptions stemming from traumatic childbirth and emphasizes the significance of clinical intervention. Therefore, healthcare professionals’ greater understanding of women’s perceptions and increased concern about childbirth and respectful childbirth environments are required. In addition, based on our findings, there is a need to develop interventions that can alleviate CB-PTSD and further improve women’s mental health, particularly through women-centred interventions.

Single-session visuospatial task procedure to prevent childbirth-related posttraumatic stress disorder: a multicentre double-blind randomised controlled trial

Preventive evidence-based interventions for childbirth-related posttraumatic stress disorder (CB-PTSD) are lacking. Yet, 18.5% of women develop CB-PTSD symptoms following an unplanned caesarean section (UCS). This two-arm, multicentre, double-blind superiority trial tested the efficacy of an early single-session intervention including a visuospatial task on the prevention of maternal CB-PTSD symptoms. The intervention was delivered by trained maternity clinicians. Shortly after UCS, women were included if they gave birth to a live baby, provided consent, and perceived their childbirth as traumatic. Participants were randomly assigned to the intervention or attention-placebo group (allocation ratio 1:1). Assessments were done at birth, six weeks, and six months postpartum. Group differences in maternal CB-PTSD symptoms at six weeks (primary outcomes) and six months postpartum (secondary outcomes) were assessed with the self-report PTSD Checklist for DSM-5 (PCL-5) and by blinded research assessors with the Clinician-administered PTSD scale for DSM-5 (CAPS-5). Analysis was by intention-to-treat. The trial was prospectively registered (ClinicalTrials.gov, NCT03576586). Of the 2068 women assessed for eligibility, 166 were eligible and 146 were randomly assigned to the intervention (n = 74) or attention-placebo control group (n = 72). For the PCL-5, at six weeks, a marginally significant intervention effect was found on the total PCL-5 PTSD symptom count (β = −0.43, S.E. = 0.23, z = −1.88, p < 0.06), and on the intrusions (β = −0.73, S.E. = 0.38, z = −1.94, p < 0.0525) and arousal (β = −0.55, S.E. = 0.29, z = −1.92, p < 0.0552) clusters. At six months, a significant intervention effect on the total PCL-5 PTSD symptom count (β = −0.65, S.E. = 0.32, z = −2.04, p = 0.041, 95%CI[−1.27, −0.03]), on alterations in cognition and mood (β = −0.85, S.E. = 0.27, z = −3.15, p = 0.0016) and arousal (β = −0.56, S.E. = 0.26, z = −2.19, p < 0.0289, 95%CI[−1.07, −0.06]) clusters appeared. No group differences on the CAPS-5 emerged. Results provide evidence that this brief, single-session intervention carried out by trained clinicians can prevent the development of CB-PTSD symptoms up to six months postpartum.

Predictors of pregnancy stress and psychological birth trauma in women undergoing vaginal delivery: a cross-sectional study in China

BackgroundPsychological birth trauma exhibits a high incidence worldwide, resulting in a wide range of negative impacts on mothers, infants, couples, families and society at large through the maternal-centered ripple effect. However, there is currently limited research on psychological birth trauma in China. Social support and pregnancy stress are important influencing factors of psychological birth trauma. Consequently, this study aimed to explore predictors of pregnancy stress and psychological birth trauma in women undergoing vaginal delivery in China.MethodsThis cross-sectional study was performed at a single medical center between December 2021 and May 2022 in Hangzhou, China. Participants were selected using a convenience sampling technique. A total of 351 postpartum women within one week after vaginal delivery were included. Questionnaires were used to collect sociodemographic and obstetric characteristics and scores on the Pregnancy Stress Rating Scale (PSRS), City Birth Trauma Scale (City BiTS), Social Support Rating Scale (SSRS) and Family Adaptation Partnership Growth Affection and Resolve index (Family APGAR). Both univariate analysis and multiple linear regression analysis were conducted to assess predictors of pregnancy stress and psychological birth trauma.ResultsThe median (IQR) of PSRS and City BiTS scores were 10.00 (14.00) and 3.00 (9.00), respectively. The incidence of postpartum posttraumatic stress disorder was 4.0% (14/351). Parity, social support, family support and level of education were predictors of pregnancy stress. Delivery complications, psychological traumatic event, pregnancy stress and family support were predictors of psychological birth trauma (P < 0.05).ConclusionPregnancy stress is related to social support, family support and some sociodemographic and obstetric characteristics. Psychological birth trauma is correlated with delivery complications, psychological traumatic event, pregnancy stress and family support. Consequently, enhancing social support, especially family support, for pregnant women as a means of reducing pregnancy stress can effectively prevent psychological birth trauma.

Perineal tear and childbirth-related posttraumatic stress: A prospective cohort study.

Quantitative studies examining the occurrence of childbirth-related posttraumatic stress disorder (CB-PTSD) following severe perineal rupture are lacking. The objective of this population-based study was to investigate the prospective associations between the degree of perineal tear during childbirth and CB-PTSD symptoms, when adjusting for known covariates (maternal age, years of school education, premature birth, and parity). We hypothesized that women with different degrees of perineal tear will differ regarding (1) the level of CB-PTSD symptoms at 8 weeks and 2 years postpartum and (2) the rate of change in CB-PTSD symptoms from 8 weeks to 2 years postpartum. Secondary data analysis from the Akershus Birth Cohort, a large population-based prospective cohort study using self-report questionnaires and hospital record data. The degree of perineal tear was significantly associated with CB-PTSD symptoms at 8 weeks and 2 years postpartum. However, the degree of perineal tear was not significantly associated with the change in CB-PTSD symptoms over time. Similar patterns were found for both total CB-PTSD symptoms as well as for avoidance and intrusion symptoms only. Results seem to support a dose-response model, suggesting that the higher the severity of the perineal tear, the higher the posttraumatic morbidity.

Dyadic analyses on the prospective association between birth experience and parent-child-bonding: The role of postpartum depression, anxiety, and childbirth-related posttraumatic stress disorder

ObjectiveNegative birth experiences are associated with postpartum mental health difficulties in parents. However, research considering the long-term impact of a negative birth experience on parent-child-bonding and the interdependence between parents is rare. This study aimed to investigate actor as well as partner effects for the association between parents’ birth experience and parent-child-bonding and whether this association is mediated by postpartum psychiatric symptoms. MethodA community sample of couples (N = 743) completed questionnaires during pregnancy, 2, and 14 months after birth. ResultsApplying Actor-Partner Interdependence Mediation Models, structural equation modeling showed that parents’ own negative birth experience predicted a poorer bond to their child 14 months postpartum. Compared to mothers, this association was twice as strong for partners and was mediated by symptoms of postpartum depression (mothers and partners), anxiety (partners), and childbirth-related posttraumatic stress disorder (mothers). Negative birth experiences of one parent were not related to the other parent’s bonding with the child. ConclusionResults underline the importance of parents’ positive birth experience for their postpartum mental health and secure bond to their child. The other parent’s birth experience or postpartum mental health does not seem to affect one’s own bond to the child in the long term.

Посттравматическое стрессовое расстройство после родов: обзор исследований

&lt;p style="text-align: justify;"&gt;Postpartum posttraumatic stress disorder (PP-PTSD) is quite common, with long-term adverse impact on mothers and their children. According to various studies, 3% to 45.5% of women perceive their childbirth experience as traumatic, and 3.1% to 43% further develop postpartum posttraumatic stress disorder. PP-PTSD is a relatively new field of study, therefore, there is a need in systematization of the data published on this topic so far. This is a review of studies on risk factors for PP-PTSD, including past traumatic experience, and its negative impact on mother&amp;rsquo;s mental health and child&amp;rsquo;s development. Since the society and specialists aim to reduce the prevalence of the disorder, our article also summarizes data on protective factors for PP-PTSD. For example, adequate interaction between laboring women and medical personnel, non-medical labour support, and psychological counseling after traumatic childbirth can significantly reduce the risk for developing PP-PTSD.&lt;/p&gt;