Perception of obstetric violence and risk of post-traumatic stress disorder at 6 months postpartum: an observational study.

INTRODUCTION

Childbirth, traditionally viewed as a natural and positive process, can become a traumatic experience when obstetric violence or disrespectful treatment occurs. This type of experience can cause symptoms consistent with Post-Traumatic Stress Disorder negatively affecting maternal mental health, bonding with the newborn, and the development of the newborn.

OBJECTIVES

To analyze the relationship between perceptions of inadequate treatment during childbirth and the risk of postpartum Post-Traumatic Stress Disorder at 6 months in a sample of women assessed 3 months after birth.

METHODS

An observational study with six-month follow-up was conducted in 341 women in Spain, initially recruited 3 months postpartum. Validated questionnaires were used: Childbirth Abuse and Respect Evaluation-Maternal Questionnaire (perceived abuse or disrespect), Perinatal Post Traumatic Stress Disorder, Family Apgar, and MOS social support survey Bivariate and multivariate analyses were performed using logistic regression.

RESULTS

Three hundred forty-one women participated, with a mean age of 33.38 years (SD = 4.23). 10.9% of the participants were at risk of Post-Traumatic Stress Disorder. Childbirth Abuse and Respect Evaluation-Maternal Questionnaire dimensions correlated positively with the Perinatal Post Traumatic Stress Disorder, with "inappropriate treatment by professionals" being the most significant (r = 0.60; 95% CI: 0.53-0.67). A greater perception of obstetric violence (Abuse and Respect Evaluation-Maternal Questionnaire ≥ P95) significantly increased the likelihood of developing Perinatal Post Traumatic Stress Disorder (aOR: 48.38; 95%CI: 10.07-232.44). Associations with risk of developing Post-Traumatic Stress Disorder were also observed for instrumental birth (aOR: 5.29; 95% CI: 1.53-18.28) and previous cesarean section (aOR: 7.54; 95% CI: 1.10-51.79). More social support was associated with a lower risk of Post-Traumatic Stress Disorder (aOR: 0.96; 95%CI: 0.94-0.99).

DISCUSSION AND

CONCLUSION

A higher perception of obstetric violence is associated with an increased risk of developing postpartum Post-Traumatic Stress Disorder. Furthermore, invasive interventions such as instrumental births or previous cesarean sections increase psychological vulnerability. In contrast, social support acts as a protective factor. It is recommended to implement screening tools such as Abuse and Respect Evaluation-Maternal Questionnaire, reinforce training in respectful treatment, and promote humane care models to ensure the physical and emotional safety of women.