Factors Associated with Postpartum Post-Traumatic Stress Disorder (PTSD) Following Obstetric Violence: A Cross-Sectional Study

Martínez‐Vázquez, Sergio; Rodríguez‐Almagro, Julián; Hernández‐Martínez, Antonio; Martínez‐Galiano, Juan Miguel

doi:10.3390/jpm11050338

Cited by 32 publications

(43 citation statements)

References 45 publications

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“…Obstetric violence, lack of ethical considerations, and poor communication remain the acute problem of the Russian maternal healthcare system [ 32 ]. Our data shows that obstetric violence is associated with higher PTSD and depression risks after delivery, which is consistent with other recent studies [ 33 ]. However, there is a lack of data on the topic across the countries.…”

Section: Discussionsupporting

confidence: 93%

Birth Experience, Postpartum PTSD and Depression before and during the Pandemic of COVID-19 in Russia

Yakupova¹,

Suarez²,

Kharchenko³

2021

IJERPH

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The aim of the study is to investigate the changes in the maternal healthcare system during the pandemic and their associations with maternal mental health in Russia. A sample of Russian women who gave birth during the first year of the COVID-19 pandemic (n = 1645) and matched controls, i.e., women who gave birth before the COVID-19 pandemic (n = 611), completed an anonymous Internet survey about recent childbirth. They were assessed for childbirth-related posttraumatic stress disorder (PTSD) and postpartum depression (PPD). Clinically relevant symptoms of PPD and PTSD were high before the pandemic and showed no significant change during the pandemic (p = 0.48 and p = 0.64, respectively). We found a notable increase in the frequency of obstetric violence (p = 0.015) during the pandemic, which, in turn, has a strong correlation with birth-related PTSD and PPD. The problem of ethical communication with patients among maternal healthcare professionals is acute in Russia, and it has been exacerbated by the pandemic. Family and doula support during labor can be a potential protective factor against obstetric violence.

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Section: Discussionsupporting

confidence: 93%

Birth Experience, Postpartum PTSD and Depression before and during the Pandemic of COVID-19 in Russia

Yakupova¹,

Suarez²,

Kharchenko³

2021

IJERPH

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“…Experiencing a caesarean delivery, or an emergency delivery are the most influential risk factors (OR = 3.79; 95% CI = 2.43–5.92) [ 18 ] in triggering PTSD after childbirth [ 14 , 15 , 16 , 17 , 18 , 19 , 22 ]. In this context there is an association of obstetric interventions and obstetric violence with PTSD after birth [ 15 , 23 ].…”

Section: Resultsmentioning

confidence: 99%

“…In this context there is an association of obstetric interventions and obstetric violence with PTSD after birth [ 15 , 23 ]. Both third- and fourth-degree perineal tears have been associated with the development of PTSD after birth (OR = 2.77; 95% CI: 1.71–4.49) [ 22 ], as well as receiving uterine pressure or manual removal of the placenta (OR = 1.41; 95% CI = 1.03, 1.93) [ 17 , 18 ]. The feeling of fear of delivery is one of the major risk factors (OR = 3.47, 95%; CI = 1.68–7.19) [ 20 ], for developing PTSD after childbirth [ 7 , 16 , 20 , 21 , 24 , 25 ].…”

Section: Resultsmentioning

confidence: 99%

“…Childbirth complications, such as lower likelihood of co-homing, lack of skin-to-skin contact, and an absent of breastfeeding, have been associated with PTSD after birth [ 19 ]. These birth complications can be traced to problems in the newborn itself, such as newborn admission to Neonatal Intensive Care Units (NICU) [ 21 , 22 , 26 , 27 ], newborn admission to incubator [ 28 ], newborn admission to neonatal intermediate care, lower neonatal birth-weight [ 19 ], and infant experiencing actual or threatened injury [ 10 ]. Other factors related to PTSD are having a preterm birth (OR = 3.8; 95% CI = 0.27–53.16) [ 16 ], giving birth before arriving at hospital [ 24 ], primiparity (OR = 3.84; 95% CI = 0.99–2.11) [ 19 ], the Kristeller’s manoeuvre, lack of analgesic use during labour, or general anaesthesia [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ].…”

Section: Resultsmentioning

confidence: 99%

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Risk Factors for Post-Traumatic Stress Disorder after Childbirth: A Systematic Review

et al. 2022

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Background: Post-traumatic stress disorder (PTSD) after birth has generated a growing interest in recent years. Although some risk factors associated with PTSD have been studied, information is still scarce to date on risk factors associated with PTSD. This systematic review aims to identify risk factors associated with the diagnosis of PTSD after childbirth. Methods: We searched on PubMed, Web of Science and SCOPUS databases, from inception to May 2022. Quality assessment of the articles was performed using the Newcastle-Ottawa Quality Assessment (“NOQAS”) scale. This systematic review was performed according to the PRISMA guidelines. Inclusion criteria were women with age ≥ 18 years; articles in English or Spanish; articles focused on physical, social, psychological, medical-obstetric, and environmental risk factors. Results: A total of n = 17,675 women were included among the studies in this systematic review. The main risk factors associated with PTSD after birth were obstetric interventions and obstetric violence such as emergency caesarean section or a non-compliant birth plan, a previous mental illness, having suffered from of a traumatic event or depression and/or anxiety, and having poor social support throughout pregnancy and/or during birth. Conclusions: Obstetric interventions, obstetric violence, experiencing a traumatic event or depression and/or anxiety, and a previous mental illness are factors associated with the diagnosis of PTSD after birth. Protective factors are multiparity, adherence to the mother’s birth plan and skin-to-skin contact.

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“…In the international context, studies show the existence of an association between traumatic experiences in childbirth and higher incidence of post-traumatic stress, anxiety and depression in the early (one week after birth) and late postpartum (04, 06, 12 and 24 weeks postpartum) [22][23][24]. In this same direction, the results of research conducted in Brazil demonstrated an association between having suffered disrespect, abuse or mistreatment during childbirth and having PPD [10,25].…”

Section: Introductionmentioning

confidence: 89%

Association between mistreatment of women during childbirth and symptoms suggestive of postpartum depression

Paiz

Castro

Giugliani

et al. 2022

BMC Pregnancy Childbirth

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Background Postpartum depression is a common condition in the pregnancy and postpartum cycle. The development of this condition is multifactorial and can be influenced by previous traumas. This study sought to verify whether there is an association between having been exposed to mistreatment during childbirth and presenting symptoms suggestive of postpartum depression. Methods This is a cross-sectional study, with the inclusion of 287 women without complications in childbirth, randomly selected from two maternity hospitals of Porto Alegre, southern Brazil, in 2016. Four weeks after delivery, the postpartum women answered a face-to-face interview about socioeconomic aspects, obstetric history, health history, and childbirth experience (practices and interventions applied) and completed the Edinburgh Postnatal Depression Scale (EPDS). From the perception of women regarding the practices performed in the context of childbirth care, a composite variable was created, using item response theory, to measure the level of mistreatment during childbirth. The items that made up this variable were: absence of a companion during delivery, feeling insecure and not welcome, lack of privacy, lack of skin-to-skin contact after delivery, not having understood the information shared with them, and not having felt comfortable to ask questions and make decisions about their care. To define symptoms suggestive of postpartum depression, reflecting on increased probability of this condition, the EPDS score was set at ≥ 8. Poisson Regression with robust variance estimation was used for modeling. Results Women who experienced mistreatment during childbirth had a higher prevalence of symptoms suggestive of postpartum depression (PR 1.55 95% CI 1.07–2.25), as well as those with a history of mental health problems (PR 1.69 95% CI 1.16–2.47), while higher socioeconomic status (A and B) had an inverse association (PR 0.53 95% CI 0.33–0.83). Conclusions Symptoms suggestive of postpartum depression seem to be more prevalent in women who have suffered mistreatment during childbirth, of low socioeconomic status, and with a history of mental health problems. Thus, qualifying care for women during pregnancy, childbirth and postpartum and reducing social inequalities are challenges to be faced in order to eliminate mistreatment during childbirth and reduce the occurrence of postpartum depression.

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Factors Associated with Postpartum Post-Traumatic Stress Disorder (PTSD) Following Obstetric Violence: A Cross-Sectional Study

Cited by 32 publications

References 45 publications

Birth Experience, Postpartum PTSD and Depression before and during the Pandemic of COVID-19 in Russia

Birth Experience, Postpartum PTSD and Depression before and during the Pandemic of COVID-19 in Russia

Risk Factors for Post-Traumatic Stress Disorder after Childbirth: A Systematic Review

Association between mistreatment of women during childbirth and symptoms suggestive of postpartum depression

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