The impact of disrespectful care during childbirth on maternal mental health: postpartum depression and suicidal ideation 6-9 months after birth.

INTRODUCTION

Postpartum depression is a common mental health disorder that has negative consequences for the mother, the family environment, and the newborn's development. In severe cases, it can be accompanied by suicidal ideation, posing a significant risk to maternal health and the mother-child bond. Recently, studies have begun to investigate how obstetric violence during childbirth, which many women experience, can negatively impact their mental health. The objective of this study was to assess the relationship between inappropriate or disrespectful treatment during birth and the presence of postpartum depression and suicidal ideation six to nine months after delivery.

METHODS

A cross-sectional observational study was conducted with women who were 6-9 months postpartum in Spain. The Edinburgh Postnatal Depression Scale was used to determine the risk of postpartum depression, and item 10 was used to identify suicide risk. The Childbirth Abuse and Respect Assessment-Maternal Questionnaire was used to assess women's experiences of inappropriate treatment during childbirth. To evaluate social support, the family APGAR, the Medical Outcomes Study Social Support Survey, and the Woman Abuse Screening Tool were used. Adjusted ORs and their 95% CI were calculated. 341 women participated.

RESULTS

Two risk factors associated with postpartum depression were identified: hospital readmission (OR: 7.19; 95% CI: 1.56-33.15) and elevated scores on the Childbirth Abuse and Respect Evaluation-Maternal Questionnaire (CARE-MQ). Regarding the latter, a dose-response pattern was observed: scores at the 70th-90th percentile were associated with a moderate increase in risk (OR: 2.48; 95% CI: 1.05-5.88), while scores above the 90th percentile were associated with a substantially greater risk (OR: 5.26; 95% CI: 2.35-11.79). Regarding suicidal ideation, hospitalization of the newborn (OR: 2.66; 95% CI: 1.14-6.18) was identified as a risk factor, while high scores on the family APGAR test (OR: 0.86; 95% CI: 0.80-0.92) acted as a protective factor for its occurrence.

CONCLUSIONS

Inadequate care during birth has been identified as a significant risk factor for the development of postpartum depression between 6 and 9 months after birth. However, this association has not been observed in relation to suicidal ideation.