Maternal childbirth-related posttraumatic stress symptoms, bonding, and infant development: a prospective study

Stress responses of infants and mothers to a still-face paradigm after traumatic childbirth

INTRODUCTION

One-third of women experience childbirth as traumatic and some develop symptoms of childbirth-related posttraumatic stress symptoms (CB-PTSD symptoms). Whether CB-PTSD symptoms negatively impact on physiological and psychological stress responses in mothers and their offspring and whether they are associated with mother-infant synchrony is not clear. This study aimed to investigate stress responses of (1) mothers with CB-PTSS, (2) of their infant, and (3) the physiological mother-child-synchrony at six months postpartum.

METHOD

Psychophysiological (cortisol and vagal tone) and psychological stress responses of mothers and infant's (n=31 dyads) from the Swiss TrAumatic biRth Trial (NCT03576586) were assessed during a face-to-face still-face paradigm (FFSF-R).

RESULTS

There was a significant time effect in maternal stress responses for salivary cortisol, vagal tone, and for maternal subjective stress. As expected, mothers' subjective stress increased during the stress task and mothers vagal tone changed during the first stressful period but not during the second, whereas cortisol unexpectedly decreased over the FFSF-R. Infant negative mood increased over the experiment, but there were no physiological changes. However, a significant interaction effect for mother-infant synchrony during the second reunion period of the FFSF-R was found.

CONCLUSION

Although mothers and their infants were subjectively stressed, they showed only limited physiological stress responses.

Beyond birth trauma: A scoping review on childbirth-related post-traumatic stress disorder and early relational health in the family system

BACKGROUND

To promote optimal development for families negatively impacted by traumatic birth experiences, research is needed to understand the potentially unique effects of childbirth-related post-traumatic stress disorder (CB-PTSD) symptoms on early relational health (ERH) in the family system.

OBJECTIVE

To examine the nature and extent of current knowledge on the effect of CB-PTSD on early relational health of the family.

SEARCH STRATEGY

We utilized previously published scoping review framework and followed PRISMA-ScR reporting guidelines. Databases searched included Google Scholar, PubMed, EMBASE, and CINAHL. Search terms included Boolean strings such as "childbirth-related PTSD" AND "mother-infant relationship", OR "early relational health".

SELECTION CRITERIA

Eligible articles quantitatively assessed the predictive relationship between CB-PTSD and an early relational health construct and adequately distinguished PTSD symptoms related to childbirth from symptoms related to other traumatic experiences.

DATA COLLECTION AND ANALYSIS

Initial search yielded N = 695 records. The final study sample included N = 22 records published from 2007 to 2023. Data were charted and synthesized based on methodological characteristics and main findings.

MAIN RESULTS

Current research specifically examining adverse effects of CB-PTSD symptoms on both the mother-infant relationship and co-parent relational health is limited and has produced conflicting results. Variation in study characteristics and methodology are discussed.

CONCLUSIONS

CB-PTSD symptoms may have a significant impact on early relational health, although findings are unclear and vary by methodology used. Clinical relevance of findings related to prevention, screening, and treatment are discussed.

The relationship between maternal functioning and birth memory and trauma

AIM

This study aimed to determine the relationship between birth memory and trauma and maternal functioning in the postpartum period.

METHODS

This cross-sectional study included 584 mothers in the postpartum period between 1 January 2022 and 1 April 2022. Data were collected using a personal information form, the Barkin Index of Maternal Functioning (BIMF), the Birth Memories and Recall Questionnaire (BirthMARQ) and the City Birth Trauma Scale (CityBiTS).

RESULTS

The participants' mean scores for the overall BIMF, BirthMARQ and CityBiTS were 81.41 ± 9.28, 80.30 ± 21.21 and 15.85 ± 11.30, respectively. Their sociodemographic characteristics did not affect their maternal functioning; however, maternal functioning improved with the number of pregnancies. While emotional memory (BirthMARQ subscale) negatively affected maternal functioning (p < 0.001), the centrality of memory (BirthMARQ subscale) positively affected maternal functioning (p < 0.001). The hyperarousal (CityBiTS subscale) score significantly and negatively affected the total maternal functioning score, explaining 6 % of its variance (F = 9.176, p = 0.001).

CONCLUSION

This study demonstrated that birth memory and trauma affected maternal functioning. The mother's functional status in the postpartum period reflects the physical and psychosocial changes associated with pregnancy and birth. Therefore, for women to have positive birth memories and emotions when recalling the birth, their emotional health and physical care should be supported during labour and the postpartum period.