Frankham, Lucy J

Thorsteinsson, Einar Baldvin

Bartik, Warren

2025-03-07

<p>There is now substantial evidence that women can develop posttraumatic stress disorder (PTSD) in response to a difficult birth. Consistent with the diathesis-stress model for birth-related PTSD, research suggests that the subjective appraisal of a woman’s childbirth experience may be a more significant risk factor than objective complications (e.g., emergency caesarean, forceps delivery). Birth related PTSD is also thought to have direct effects on infant mental health, as well as significant social and economic costs. This thesis explores the consequences of birth related PTSD symptoms on the mother–infant relationship, the individual characteristics that are risk factors for birth related PTSD, and evaluates an intervention aimed at reducing or preventing birth related PTSD symptoms. A significant robust association between birth related PTSD symptoms and poorer mother– infant relationship quality is demonstrated, emphasising the relevance of the research topic. Findings relating to risk factors and the intervention are largely contrary to what was predicted, which suggests that a more comprehensive perspective on birth related PTSD that encompasses external systemic factors is needed. The impact of COVID-19 on antenatal depression further highlighted the influence of external factors on maternal well-being. An integrated theory of birth trauma using the power threat meaning framework is proposed. It is recommended that women should be routinely screened for birth related PTSD symptoms, alongside screening for postnatal depression, and those women who are identified as having experienced trauma symptoms should be offered a referral to a perinatal psychologist or mental health clinician with experience working with trauma. Policy and practice in hospital and healthcare settings should be consistent with the WHO’s recommendations for intrapartum care, including respectful woman-centred care, where women can make autonomous, informed decisions. To achieve this, birth needs to be recognised as a psychological and physiological process with important social and emotional aspects rather than as a medical event.</p>

https://hdl.handle.net/1959.11/69198

University of New England

Exploring Birth Related Posttraumatic Stress Disorder, Childbirth Self-Efficacy, and the Mother–Infant Relationship

Thesis Doctoral

Publication