The impact of subjective birth experiences on post-traumatic stress symptoms: a longitudinal study

Abstract

The aim of this prospective study was to examine the etiology of post-traumatic stress symptoms following childbirth within a transactional framework of stress. Participants were women (N = 1,499) from the Akershus Birth Cohort. These women were followed from pregnancy to 8 weeks postpartum. We modeled predisposing factors (e.g., fear of childbirth) and precipitating factors (subjective and objective birth experiences) as predictors of post-traumatic stress symptoms. Post-traumatic stress symptoms were measured by means of the Impact of Event Scale, objective birth experiences by means of birth journals, and subjective birth experiences by means of three questions. A structural equation model showed that subjective birth experiences had the highest association with post-traumatic stress symptoms. Moreover, they mediated the effect of predisposing factors and objective birth experiences. The results suggest that women's subjective birth experiences are the most important factor in the development of post-traumatic stress symptoms following childbirth.

Peritraumatic distress fully mediates the relationship between posttraumatic stress symptoms preoperative and three months postoperative in patients undergoing spine surgery

“…Even if peritraumatic distress is not included as diagnostic criterion, its relevance as risk factor should be paid attention to (Karam et al, 2010). In the study by Garthus-Niegel et al (2013), comparable results were found, using a similar design in another population. Childbirth as well as spine surgery, among other medical conditions, can serve as research opportunities to study general mechanisms in the development of PTSD.…”

“…Peritrauma variables, on the other hand, could influence posttraumatic stress either directly or indirectly through posttrauma variables occurring after the trauma. Childbirth, like elective spine surgery, is a possibly traumatizing event that is highly predictable and therefore a suitable subject for research on the relevance of pre- and peritrauma risk factors in longitudinal studies (Garthus-Niegel, Von Soest, Vollrath, & Eberhard-Gran, 2013; König et al, 2016; van Son, Verkerk, van der Hart, Komproe, & Pop, 2005). While some studies (e.g.…”

“…While some studies (e.g. König et al, 2016; van Son et al, 2005) suggest both a vulnerability and a stress pathway, Garthus-Niegel et al (2013) found that subjective experiences during birth are the most relevant predictor of PTSD symptoms.…”

Fear of childbirth, postnatal post-traumatic stress disorder and midwifery care

“…For example, a study of 1,499 women in Norway examined the role of fear of childbirth, subjective and objective experience of birth in postnatal PTSD symptoms. They found that subjective birth experience had the strongest effect on postpartum PTSD symptoms and mediated the relationships between fear of childbirth, obstetric factors and PTSD (Garthus-Niegel, von Soest, Vollrath, & Eberhard-Gran, 2013).…”

Aetiological relationships between factors associated with postnatal traumatic symptoms among Japanese primiparas and multiparas: A longitudinal study

“…A number of authors have emphasized that preventive interventions should be based on the underlying psychological mechanism of traumatic stress symptoms (Ayers et al, 2008;Garthus-Niegel et al, 2013). However, the aetiology of these symptoms remains unclear.…”