Factors Associated with Postpartum Post-Traumatic Stress Disorder (PTSD) Following Obstetric Violence: A Cross-Sectional Study

To determine the association between experiencing obstetric violence and the incidence of postpartum post-traumatic stress disorder (PTSD). A cross-sectional study with puerperal women was conducted in Spain following ethical approval. The Perinatal Posttraumatic Stress Disorder Questionnaire (PPQ) was administered online. Sociodemographic, clinical, and obstetric violence variables and the risk of dichotomized PTSD (low/high) were studied by bivariate and multivariate analysis with binary logistic regression. 955 women were invited to participate. 53 women refused to participate, three did not complete all survey questions and, finally, 899 women were included. The risk of PTSD (score >= 19) using the PPQ was 12.7% (114). The mean score was 9.10 points (SD = 8.52). Risk factors identified were having a delivery plan that was not respected (aOR: 2.85, 95% CI 1.56-5.21), elective caesarean delivery (aOR: 2.53, 95% CI 1.02-2.26), emergency caesarean section (aOR: 3.58, 95% CI 1.83-6.99), admission of the newborn to the neonatal intermediate care unit (aOR: 4.95, 95% CI 2.36-10.36), admission to the intensive care unit (aOR: 2.25, 95% CI 1.02-4.97), formula feeding on discharge (aOR: 3.57, 95% CI 1.32-9.62), verbal obstetric violence (aOR: 5.07, 95% CI 2.98-8.63), and psycho-affective obstetric violence (aOR: 2.61, 95% CI 1.45-4.67). Various clinical practices were identified with the risk of PTSD, highlighting various types of obstetric violence. Partner support and early breastfeeding were identified as protective factors. Sensitizing professionals is essential to prevent the risk of PTSD.

Automated summary

This study found an association between obstetric violence and postpartum post-traumatic stress disorder (PTSD) in puerperal women. Factors such as lack of respect for the delivery plan, emergency caesarean section, and admission of the newborn to the neonatal intermediate care unit were identified as being associated with the risk of PTSD.