Negative Childbirth Experience and Post-traumatic Stress Disorder - A Study Among Postpartum Women in South India

Purpose: Negative childbirth experience has been associated with post-traumatic stress disorder (PTSD) and depression in the postpartum period with a significant impact on the mother as well as the infant.Methods: The current study aimed at studying the association of negative child birth experience with PTSD and depressive symptoms among primiparous mothers within 6 weeks of child birth. The Childbirth Experience Questionnaire (CEQ), PTSD checklist (PCL), and Edinburgh Postnatal Depression scale (EPDS) were used to assess negative childbirth experience, symptoms of PTSD, and depression respectively.Results: Of the 95 women in the study, fifty women (52.6%) had a score below the median of CEQ score (score of 72) indicating a negative childbirth experience. Lower Scores on CEQ indicating negative childbirth experience correlated with PTSD scores on the PCL (r = −0.560, p = 0.001) and depression scores on the EPDS (r = −0.536, p = 0.001). Of the sample of 95 women, 7.36% (N = 7) met the criteria for probable PTSD and 3.16% (N = 3) met criteria for partial PTSD. Twelve women (12.6%) had EPDS scores above 13 indicating probable clinical depression. Median CEQ scores were lower among the women who had PTSD or partial PTSD (N = 10) and among the women who had probable depression (N = 12) than those who did not. Childbirth experience emerged as the only predictor of PTSD on logistic regression (p = 0.03) (95% CI 1.17–79.61).Conclusions: Negative childbirth experiences are common and appear to be associated with depressive and PTSD symptoms. These findings emphasize the need to provide good intrapartum care including respectful maternity care for a positive childbirth experience.

Validierung der deutschen Übersetzung des Childbirth Experience Questionnaire (CEQ2)

Zusammenfassung. Der Childbirth Experience Questionnaire (CEQ; Dencker, Taft, Bergqvist, Lilja & Berg, 2010 ) ist ein reliables und valides Instrument zur Erfassung der Geburtserfahrung. Ziel der Studie war, die revidierte Fassung des CEQ (CEQ2) ins Deutsche zu übersetzen und an einer Stichprobe aus 295 Wöchnerinnen zu validieren. In einer konfirmatorischen Faktorenanalyse konnte die 4-faktorielle Struktur der Originalversion nicht repliziert werden. Stattdessen wurden in einer explorativen Faktorenanalyse vier neue Faktoren gewonnen, die ähnlichen übergeordneten Facetten des Geburtserlebens zugeordnet wurden. Für die neu gewonnenen Skalen erwiesen sich die internen Konsistenzen als überwiegend zufriedenstellend bis gut. Der Zusammenhang zwischen dem CEQ2 und der konstruktnahen Salmon′s Item List ( Stadlmayr et al., 2001 ) spricht zudem für die konvergente Validität. Ebenso zeigten sich auch die erwarteten Zusammenhänge mit relevanten Außenkriterien. Die Ergebnisse dieser ersten Validierungsstudie sind somit vielversprechend, wobei weitere Studien in anderen Settings sowie im Längsschnitt wünschenswert sind.

Translation and Validation of the Mongolian Version of the Childbirth Experience Questionnaire

Women’s experiences of childbirth have a significant impact on mother and child health and well-being as well as quality of care. A valid and reliable tool is needed to assess women's experience. This study aim was to adapt the Childbirth Experience Questionnaire to the Mongolian context and assess its psychometric properties. The study conducted between October and January 2019 at the public maternity hospital in Ulaanbaatar by recruiting a total of 828 low-risk postpartum women. The response rate was 92% (n = 761). Confirmatory factor analysis indicated a good fit for the 4-factor model. Reliability was good for the overall instrument (Cronbach's alpha = 0.83) and for individual domains (Cronbach's alphas ranging from 0.45 to 0.80). The overall and domain scores were significantly higher among women who had previous birth experience, who did not receive oxytocin augmentation, and who experienced a shorter labor duration (<12 h).The Mongolian version of the Childbirth Experience Questionnaire is a valid and reliable tool for exploring the childbirth experience. It can be used to promote women-centered, respectful care in maternity hospitals.

Psychometric Evaluation of the Persian Version of the Childbirth Experience Questionnaire (CEQ)

Women’s childbirth experience is an outcome indicator for evaluating maternity care. This study evaluated the psychometric properties of the Persian version of the Childbirth Experience Questionnaire (P-CEQ). The study recruited two hundred and fifty primiparous postpartum women in the 1-3 months following birth from one private and three public hospitals in Mazandaran province, Iran. First, face validity and content validity were evaluated. Moreover, confirmatory factor analysis (CFA) was conducted, and discriminant validity was assessed by applying the known-groups method. Intraclass correlation coefficient (ICC) was measured to confirm the stability and Cronbach’s alpha to confirm the internal consistency. CFA also confirmed the values of fit indices (RMSEA = 0.05, SRMSR = 0.06, CFI >0.93, χ2/df = 1.80). ICC was 0.88 and Cronbach’s alpha for all items was 0.85. Furthermore, discriminant validity of the P-CEQ was approved given that it effectively differentiated women whose stay in the labor unit exceeded twelve hours from those with a shorter stay. The P-CEQ questionnaire is a valid and reliable tool for assessing childbirth experiences. It is an easy-to-use questionnaire that can be used for evaluating quality of care in terms of women’s childbirth experience. It can be used in maternity services that aim to improve quality of care during labor and childbirth.

The Impact of First Childbirth Experience on Women’s Attitude towards Having another Child and Subsequent Vaginal Birth

Background: Some women may consider childbirth an unpleasant event, which can influence their decisions on subsequent pregnancies and type of birth. Objective: The aim of this study was to determine the proportion of negative childbirth experience and its relationship with women’s attitudes towards subsequent pregnancy and vaginal birth. Methods: The study design was a cross-sectional. A cluster sampling was used to recruit 800 primiparous women from health centers in Tabriz, Iran. The Persian version of the Childbirth Experience Questionnaire was used to assess women’s childbirth experiences. Univariate and multivariate logistic regression was used to assess the impact of childbirth experiences on women’s attitudes towards subsequent pregnancy and vaginal birth. Results: Thirty-seven percent of women reported a negative childbirth experience. There was a statistically significant relationship between childbirth experience and the attitude of women towards subsequent pregnancy (p<0.001) and vaginal birth (p<0.001). By controlling the effects of potential confounding variables such as socio demographic characteristics, negative childbirth experience was found to be an independent predictive factor for women’s reluctance towards subsequent pregnancies [OR= 0.42 (CI 95%: 0.57 to 0.31), p<0.001] and vaginal birth [OR= 0.08 (CI 95%: 0.14 to 0.04); p<0.001]. Conclusion: Negative childbirth experience is associated with a reduced willingness for women to get pregnant again and have vaginal birth. It is recommended that key stakeholders pay attention to strategies to improve childbirth experiences among primiparous women in Iran.