Journal of affective disorders · 2026
Psychological predictors of childbirth-related PTSD: The role of obstetric violence, childbirth satisfaction, and ego-resiliency.
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Morawiec Natalia, Ilska Michalina
Аннотация
BACKGROUND: Traumatic childbirth experiences are reported by 9-50% of women, with childbirth-related posttraumatic stress disorder (CB-PTSD) affecting 3.1-4.7%. This study aimed to assess psychological predictors of CB-PTSD, focusing on obstetric violence, childbirth satisfaction, and ego-resiliency, while also examining sociodemographic and obstetric variables, including postpartum blues symptoms.
METHODS: A cross-sectional study was conducted among 439 postpartum women (6 weeks-12 months) via social media in Poland. Participants completed questionnaires assessing sociodemographic and obstetric characteristics, CB-PTSD symptoms (City BiTS), obstetric violence (OVS), childbirth satisfaction (BSS), and ego-resiliency (ER).
RESULTS: Hierarchical regression showed that in Step 1, low birth weight, emergency cesarean birth, and the presence of postpartum blues emerged as significant predictors of higher CB-PTSD symptoms. In Step 2, after adding psychological variables, obstetric violence and lower levels of childbirth satisfaction and ego-resiliency were strong predictors of CB-PTSD. Postpartum blues and low birth weight remained significant contextual factors. The final model explained 45% of the variance in CB-PTSD symptoms. Mediation analysis revealed a significant indirect effect of obstetric violence on CB-PTSD through childbirth satisfaction. In contrast, ego-resiliency was a significant unique predictor of symptom severity but did not function as a mediator in this relationship.
CONCLUSIONS: Obstetric violence, childbirth satisfaction, and ego-resiliency are key factors in CB-PTSD. While childbirth satisfaction accounts for the indirect association between obstetric violence and PTSD symptoms, ego-resiliency functions as an independent protective factor. The postpartum blues correlate significantly with CB-PTSD, highlighting the need for early postpartum psychological support. Improving childbirth experiences and fostering resilience may help mitigate PTSD risk in postpartum women.
METHODS: A cross-sectional study was conducted among 439 postpartum women (6 weeks-12 months) via social media in Poland. Participants completed questionnaires assessing sociodemographic and obstetric characteristics, CB-PTSD symptoms (City BiTS), obstetric violence (OVS), childbirth satisfaction (BSS), and ego-resiliency (ER).
RESULTS: Hierarchical regression showed that in Step 1, low birth weight, emergency cesarean birth, and the presence of postpartum blues emerged as significant predictors of higher CB-PTSD symptoms. In Step 2, after adding psychological variables, obstetric violence and lower levels of childbirth satisfaction and ego-resiliency were strong predictors of CB-PTSD. Postpartum blues and low birth weight remained significant contextual factors. The final model explained 45% of the variance in CB-PTSD symptoms. Mediation analysis revealed a significant indirect effect of obstetric violence on CB-PTSD through childbirth satisfaction. In contrast, ego-resiliency was a significant unique predictor of symptom severity but did not function as a mediator in this relationship.
CONCLUSIONS: Obstetric violence, childbirth satisfaction, and ego-resiliency are key factors in CB-PTSD. While childbirth satisfaction accounts for the indirect association between obstetric violence and PTSD symptoms, ego-resiliency functions as an independent protective factor. The postpartum blues correlate significantly with CB-PTSD, highlighting the need for early postpartum psychological support. Improving childbirth experiences and fostering resilience may help mitigate PTSD risk in postpartum women.