Relationship between the perception of disrespectful treatment and abuse during childbirth and the risk of postpartum post-traumatic stress disorder: a PPQ-based study.

Abstract

Problem: Childbirth is often portrayed as a positive and empowering experience, yet for many women, it can result in negative emotional outcomes, which may contribute to the development of postpartum Post-Traumatic Stress Disorder (PTSD). Understanding the association between perceived abuse during childbirth and PTSD is crucial for improving maternal care.

Background: Research shows that disrespectful and abusive treatment during childbirth is linked to psychological distress and PTSD. However, the correlation between perceived abuse and PTSD in postpartum women remains underexplored.

Aim: To determine the association between the woman's perception of abuse during childbirth and the risk of developing PTSD postpartum, as well as to analyze related risk factors.

Methods: A cross-sectional observational study was conducted with 2,912 women in Spain who gave birth in the last 18 months. The Childbirth Abuse and Respect Evaluation- Maternal Questionnaire (CARE-MQ) assessed perceived abuse, while the Perinatal PTSD Questionnaire (PPQ) measured PTSD risk. Logistic regression was used to adjust for confounders.

Findings: Higher CARE-MQ scores were positively correlated with PTSD risk, especially in the "inadequate treatment by professionals" dimension (r = 0.56). Extreme perception of abuse (≥95th percentile) increased the PTSD risk (aOR = 34.72). Additional risk factors included extremely premature birth, unrespected birth plans, complications, type of birth and emergency cesarean sections.

Discussion: Perceived mistreatment and inadequate professional care strongly correlate with PTSD risk.

Conclusion: Addressing these factors-along with other identified risks-may help reduce PTSD prevalence and improve maternal care experiences.