Fear of Childbirth, Postpartum Depression, and Birth‐Related Variables as Predictors of Posttraumatic Stress Disorder After Childbirth

Abstract

Background: Childbirth may be a significant cause of postpartum posttraumatic stress disorder (PTSD) in women.Aims: The objective of this study is to examine the effect of fear of childbirth, postpartum depression, and certain birth-related variables on postpartum PTSD. Methods:This study is a cross-sectional study. The study was carried out in a maternity hospital nonstress unit between December 1, 2015, and February 29, 2016. Three hundred and one pregnant women who met the criteria for inclusion in the study made up the research sample.Results: Fear of childbirth and postpartum depression significantly and positively predicted the level of posttraumatic stress after childbirth (β = 0.17, p < .01; β = 0.68, p < .001). Fear of childbirth explains 3% of the total variance in posttraumatic stress (R 2 = .03, adjusted R 2 = .02, F = 7.141, p < .01), while postpartum depression explains 47% of it (R 2 = .47, adjusted R 2 = .46, F = 196.35, p < .001). Satisfaction with the attitudes of the medical staff during childbirth, defining the childbirth experience, and the state of experiencing postpartum problems by the mother are significant predictors of postpartum posttraumatic stress (β = −0.21, p < .01; β = −0.14, p < .05; β = 0.17, p < .01). When these three variables are addressed together, they explain 14% of the total variance (R 2 = .14, adjusted R 2 = .13, F = 9.33, p < .001).Linking Evidence to Action: Postpartum PTSD is a situation that must be carefully emphasized in terms of maternal, baby, and family health. For this reason, it is necessary to evaluate postpartum PTSD more quickly and objectively, and healthcare providers have major duties in this respect.

The risk factors for postpartum posttraumatic stress disorder and depression

“…In this study, women who had developed complications during or immediately after birth obtained higher PP-PTSD scores, and this finding is consistent with the literature 14,17,19,28,29 ; indeed, some complications and interventions are inevitable during childbirth.…”

“…11 Other studies that have assessed PP-PTSD symptoms have reported figures that range from 3% to 39%. 7,13,14 These rates may have varied widely because the studies used different samples and examined different phases of the postpartum period. There was a strong correlation between the CityBiTS and EPDS scores, and this finding is similar to those that have previously been reported in the literature.…”

“…According to the literature, PP-PTSD is more common among women who do not feel sufficiently supported during the birthing process, 19,22,25,30 feel despondent, lack help, and have to cope with the negative attitudes that they are confronted with. 3,6,14 Therefore, we believe that the uninterrupted management of a normal delivery by a midwife will help us to significantly reduce the risk of PP-PTSD.…”

“…Other studies that have assessed PP‐PTSD symptoms have reported figures that range from 3% to 39% 7,13,14 . These rates may have varied widely because the studies used different samples and examined different phases of the postpartum period.…”

“…In this study, higher CityBiTS scores were reported by (a) women whose privacy had not been respected during labor, (b) women who were confronted with the negative attitudes of health care personnel, and (c) women who did not have the support of primary midwives during the birthing process. According to the literature, PP‐PTSD is more common among women who do not feel sufficiently supported during the birthing process, 19,22,25,30 feel despondent, lack help, and have to cope with the negative attitudes that they are confronted with 3,6,14 . Therefore, we believe that the uninterrupted management of a normal delivery by a midwife will help us to significantly reduce the risk of PP‐PTSD.…”