The Relationship between Experience of Antepartum Intervention with Post-Traumatic Stress Symptoms following Childbirth: A Prospective Study

Childbirth is an event in the life of a woman that, if it is associated with a negative memory in mind, it leads to negative psychological reactions and disturbs the mother’s mental health during the postpartum period. The aim of the present study was to assess the relationship between experiences of antepartum intervention with post-traumatic stress symptoms following childbirth. The sample comprised 176 Iranian women, with assessments at 8 weeks after postpartum. Current PTSD was assessed by the Impact of Events Scale – Revised (IES-R). Data were collected on obstetric variables. Data were analyzed with SPSS version 19.0. The adjusted odds ratios were estimated by binary logistic regression. 38.3% (N=62) of the women appeared at risk for PTSD symptoms. The mean score of PTSD symptoms was 22.51±12.04 (0-65). The results showed that women in PTSD group underwent more obstetrical interventions than women without PTSD during childbirth (p=0.002) and experienced childbirth pain (p=0.048). Insertion of sublingual or vaginal prostaglandin tab, experience of episiotomy incision, perineal/labial/vaginal sutures and artificial rupture of amniotic membranes correlated significantly with PTSD symptoms (P<0.05). The results of binary logistic regression analysis confirmed that the rate of obstetrical interventions was the significant predictor of PTSD after childbirth (Odd ratio=1.284; p=0.008). The findings indicated that by enhancing health provider's understanding of obstetric intervention consequences, opportunities are provided to prevent PTSD through providing physiological delivery and supportive care in labor.