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

Khsim, Ijlas El Founti; Rodríguez, Mirella Martínez; Riquelme-Gallego, Blanca; Caparrós-González, Rafael A.; Amezcua-Prieto, Carmen

doi:10.3390/diagnostics12112598

Cited by 21 publications

(13 citation statements)

References 39 publications

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“…Surprisingly, we observed the practice of episiotomy is significantly associated with lower levels of CB-PTSD, compared to women with no episiotomy. On the contrary, other studies find obstetric interventions such as episiotomy to be a risk factor of CB-PTSD [ 19 – 21 ]. These findings continue to worry health researchers and professionals which bring growing interest to CB-PTSD, PPD and their associated risk factors [ 21 – 24 ].…”

Section: Discussionmentioning

confidence: 96%

Disrespect during childbirth and postpartum mental health: a French cohort study

Leavy

Cortet

Huissoud

et al. 2023

BMC Pregnancy Childbirth

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Background While the World Health Organisation (WHO) warned about mistreatment, disrespect and/or abuse during childbirth as early as 2014. This same year a social media movement with #payetonuterus brought to light the problematic of obstetrical violence in French speaking countries, and more specifically on issues of disrespect. The experience of care is an integral part of the quality of care, and perception on inadequate support during labour and loss of control in labour are some of the most frequently reported risk factors for childbirth-related post-traumatic stress disorder (CB-PTSD). Therefore, it seems crucial to study the associations between disrespect during childbirth and the mental well-being of mothers. Methods We performed a multicentered cohort study using auto-questionnaires within a French perinatal network. The main outcome was women’s report of disrespect during childbirth measured by the Behavior of the Mother’s Caregivers – Satisfaction Questionnaire (BMC-SQ) 3 days and 2 months after childbirth. CB-PTSD and Postpartum Depression (PPD) were assessed 2 months after childbirth using respectively the Post-Traumatic Checklist Scale (PCLS) and the Edinburgh Postnatal Depression Scale (EPDS). Results This study followed 123 mothers from childbirth to 2 months postpartum. Among them, 8.13% (n = 10/123) reported disrespect during childbirth at 3 days after childbirth. With retrospect, 10.56% (n = 13/123) reported disrespect during childbirth at 2 months postpartum, i.e. an increase of 31%. Some 10.56% (n = 13/123) of mothers suffered from postpartum depression, and 4.06% (n = 5/123) were considered to have CB-PTSD at 2 months after childbirth. Reported disrespect during childbirth 3 days after birth was significantly associated with higher CB-PTSD 2 months after birth (R2 = 0.11, F(1,117) = 15.14, p < 0.001 and β = 9.11, p = 0.006), PPD at 2 months after childbirth was positively associated to reported disrespect in the birth room, 3 days after birth (R2 = 0.04, F(1, 117) = 6.28, p = 0.01 and β = 3.36, p = 0.096). Meanwhile, PPD and CB-PTSD were significantly associated 2 months after childbirth (R2 = 0.41, F=(1,117) = 82.39, p < 0.01 and β = 11.41, p < 0.001). Conclusions Disrespect during childbirth was associated with poorer mental health during the postpartum period. Given the high prevalence of mental health problems and the increased susceptibility to depression during the postpartum period, these correlational results highlight the importance of gaining a deeper awareness of healthcare professionals about behaviours or attitudes which might be experienced as disrespectful during childbirth.

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Section: Discussionmentioning

confidence: 96%

Disrespect during childbirth and postpartum mental health: a French cohort study

Leavy

Cortet

Huissoud

et al. 2023

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

show abstract

“…Surprisingly, we observed the practice of episiotomy is signi cantly associated with lower levels of CB-PTSD, compared to women with no episiotomy. On the contrary, other studies nd obstetric interventions such as episiotomy to be a risk factor of CB-PTSD [19][20][21]. These ndings continue to worry health researchers and professionals which bring growing interest to CB-PTSD, PPD and their associated risk factors [21][22][23][24].…”

Section: Discussionmentioning

confidence: 98%

Disrespect during childbirth and postpartum mental health: a French cohort study

Leavy¹,

Cortet

Huissoud

et al. 2023

Preprint

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Background: While the World Health Organisation (WHO) warned about disrespect and abuse during childbirth as early as 2014. This same year a social media movement with #payetonuterus brought to light the problematic of obstetrical violence in French speaking countries. The experience of care is an integral part of the quality of care, and perception on inadequate support during labour and loss of control in labour are some of the most frequently reported risk factors for childbirth-related post-traumatic stress disorder (CB-PTSD). Therefore, it seems crucial to study the associations between disrespect during childbirth and the mental well-being of mothers. Methods: We performed a multicentered cohort study using auto-questionnaires within a French perinatal network. The main outcome was women’s report of disrespect during childbirth measured by the Behavior of the Mother’s Caregivers – Satisfaction Questionnaire (BMC-SQ) 3 days and 2 months after childbirth. CB-PTSD and Postpartum Depression (PPD) were assessed 2 months after childbirth using respectively the Post-Traumatic Checklist Scale (PCLS) and the Edinburgh Postnatal Depression Scale (EPDS). Results: This study followed 123 mothers from childbirth to 2 months postpartum. Among them, 8.13% (n=10/123) reported disrespect during childbirth at 3 days after childbirth. With retrospect, 10.56% (n=13/123) reported disrespect during childbirth at 2 months postpartum, i.e. an increase of 31%. Some 10.56% (n=13/123) of mothers suffered from postpartum depression, and 4.06% (n=5/123) were considered to have CB-PTSD at 2 months after childbirth. Reported disrespect during childbirth 3 days after birth was significantly associated with higher CB-PTSD 2 months after birth (R2=0.11, F(1,117)=15.14, p<0.001 and β=9.11, p=0.006), PPD at 2 months after childbirth was positively associated to reported disrespect in the delivery room, 3 days after birth (R2=0.04, F(1, 117)=6.28, p=0.01 and β=3.36, p=0.096). Meanwhile, PPD and CB-PTSD were significantly associated 2 months after childbirth (R2=0.41, F=(1,117)=82.39, p<0.01 and β=11.41, p<0.001). Conclusions: Disrespect during childbirth was associated with poorer mental health during the postpartum period. Given the high prevalence of mental health problems and the increased susceptibility to depression during the postpartum period, these correlational results highlight the importance of gaining a deeper awareness of healthcare professionals about behaviours or attitudes which might be experienced as disrespectful during childbirth.

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“…However, in our opinion, they should be considered different constructs, so they should be measured with different instruments. Moreover, there are certain fears and concerns in women that may be directly related to previous experiences [ 15 , 16 , 67 ]. This is a possible explanation for the behaviour of the item.…”

Section: Discussionmentioning

confidence: 99%

Cultural adaptation, validation and evaluation of the psychometric properties of Childbirth Experience Questionnaire version 2.0 in the Spanish context

Machín-Martín,

González-de la Torre,

Bordón-Reyes

et al. 2024

BMC Pregnancy Childbirth

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Background Several instruments have been designed to assess the childbirth experience. The Childbirth Experience Questionnaire (CEQ) is one of the most widely used tools. There is an improved version of this instrument, the Childbirth Experience Questionnaire (CEQ 2.0), which has not been adapted or validated for use in Spain. The aim of present study is to adapt the CEQ 2.0 to the Spanish context and evaluate its psychometric properties. Methods This research was carried out in 2 stages. In the first stage, a methodological study was carried out in which the instrument was translated and back-translated, content validity was assessed by 10 experts (by calculating Aiken's V coefficient) and face validity was assessed in a sample of 30 postpartum women. In the second stage, a cross-sectional study was carried out to evaluate construct validity by using confirmatory factor analysis, reliability evaluation (internal consistency and temporal stability) and validation by known groups. Results In Stage 1, a Spanish version of the CEQ 2.0 (CEQ-E 2.0) was obtained with adequate face and content validity, with Aiken V scores greater than 0.70 for all items. A final sample of 500 women participated in Stage 2 of the study. The fit values for the obtained four-domain model were RMSEA = 0.038 [95% CI: 0.038–0.042], CFI = 0.989 [95% CI: 0.984–0.991], and GFI = 0.990 [95% CI: 0.982–0.991]. The overall Omega and Cronbach's Alpha coefficients were 0.872 [95% CI: 0.850–0.891] and 0.870 [95% CI: 0.849–0.890] respectively. A coefficient of intraclass correlation of 0.824 [95% CI: 0.314–0.936] (p ≤ 0.001) and a concordance coefficient of 0.694 [95% CI: 0.523–0.811] were obtained. Conclusions The Spanish version of CEQ 2.0 (CEQ-E 2.0), has adequate psychometric properties and is a valid, useful, and reliable instrument for assessing the childbirth experience in Spanish women.

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

Cited by 21 publications

References 39 publications

Disrespect during childbirth and postpartum mental health: a French cohort study

Disrespect during childbirth and postpartum mental health: a French cohort study

Disrespect during childbirth and postpartum mental health: a French cohort study

Cultural adaptation, validation and evaluation of the psychometric properties of Childbirth Experience Questionnaire version 2.0 in the Spanish context

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