Birth Trauma: The Role of Obstetric Complications and Perceptions of Care Across the Perinatal Period
Chelsea Walker‐Mao, Charlotte V. Farewell, Heather L. Smyth, Mickey Sperlich, Winnifred Hunter, Jenn A. LeifermanABSTRACT
Background
Birth trauma can negatively impact maternal and family wellbeing in the short‐ and long‐term. We investigated risk and protective factors for birth trauma that are under the direct purview of providers who care for women in the perinatal period, including obstetric complications and positive perceptions of provider care.
Methods
We applied hierarchical logistic regression to secondary data collected by the Colorado Department of Public Health and Environment from a racially diverse, population‐based sample of postpartum mothers ( n = 1534) to investigate whether the number of obstetric complications across the perinatal period was associated with higher odds of birth trauma (self‐reported difficulty coping with birth experience) and whether positive perceptions of perinatal care were protective against birth trauma, controlling for sociodemographic and birth characteristics.
Results
Mothers who had more obstetric complications throughout the perinatal period had significantly higher odds of birth trauma (adjusted OR = 1.21, 95% CI: 1.05, 1.38), and mothers who had more positive perceptions of perinatal care had significantly lower odds of birth trauma (adjusted OR = 0.91, 95% CI: 0.85, 0.96). The interaction between number of obstetric complications and perceptions of perinatal care was not significant.
Discussion
Women's experience across the entire perinatal period, including complications and perceptions of care during pregnancy, labor and delivery, and postpartum, can influence their perception of birth trauma. Monitoring and attending to emotional distress and improving quality of patient–provider interactions throughout the perinatal period may help to prevent and mitigate the negative impacts of traumatic birth.