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Published in: BMC Pregnancy and Childbirth 1/2019

Open Access 01-12-2019 | Research article

Predictors of traumatic birth experience among a group of Iranian primipara women: a cross sectional study

Authors: Solmaz Ghanbari-Homayi, Zahra Fardiazar, Shahla Meedya, Sakineh Mohammad-Alizadeh-Charandabi, Mohammad Asghari-Jafarabadi, Eesa Mohammadi, Mojgan Mirghafourvand

Published in: BMC Pregnancy and Childbirth | Issue 1/2019

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Abstract

Background

Traumatic birth experience has undesirable effects on the life of the mother, child, family, and society. The identification of predictive factors can be useful in improving birth experiences among women. This study aimed to assess the prevalence of a traumatic birth experience and identify its predictors among a group primiparous women.

Methods

A cross-sectional study was conducted among 64 health centres in Tabriz, the second largest city in Iran. Cluster sampling was used to recruit 800 eligible women at one to 4 months postpartum. The Persian version of the Childbirth Experience Questionnaire was used to measure the womens’ birth experiences. Data were collected through face to face interviews and analysed mainly by multivariable logistic regression.

Results

The prevalence of traumatic birth experience was 37% in the study group. The independent predictors of the traumatic birth experience were related to antenatal and intrapartum factors. The antenatal predictor was the lack of exercise during pregnancy (OR = 2.81, CI 1.40–5.63, P = .003) and the intrapartum predictors were the absence of pain relief during labour and birth (OR = 4.24, CI 2.12–8.50, P < .001), and the fear of childbirth (OR = 3.47, CI 1.68–7.19, P < .001).

Conclusions

The findings revealed the high rate of traumatic birth experience among the primimarous women and identified the importance of a woman-centered care where a woman can actively make decision about the care she receives receive during labour and birth.
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Literature
1.
go back to reference Thomson GM, Downe S. Changing the future to change the past: women’s experiences of a positive birth following a traumatic birth experience. Journal of Reproductive and Infant Psychology. 2010;28:102–12.CrossRef Thomson GM, Downe S. Changing the future to change the past: women’s experiences of a positive birth following a traumatic birth experience. Journal of Reproductive and Infant Psychology. 2010;28:102–12.CrossRef
2.
go back to reference Simkin P. Just another day in a woman's life? Women's long-term perceptions of their first birth experience. Part I. Birth. 1991;18:203–10.CrossRef Simkin P. Just another day in a woman's life? Women's long-term perceptions of their first birth experience. Part I. Birth. 1991;18:203–10.CrossRef
3.
go back to reference Waldenström U, Schytt E. A longitudinal study of women’s memory of labour pain—from 2 months to 5 years after the birth. BJOG Int J Obstet Gynaecol. 2009;116(4):577–83.CrossRef Waldenström U, Schytt E. A longitudinal study of women’s memory of labour pain—from 2 months to 5 years after the birth. BJOG Int J Obstet Gynaecol. 2009;116(4):577–83.CrossRef
4.
go back to reference Waldenström U, Hildingsson I, Rubertsson C, Rådestad I. A negative birth experience: prevalence and risk factors in a national sample. Birth. 2004;31(1):17–27.CrossRef Waldenström U, Hildingsson I, Rubertsson C, Rådestad I. A negative birth experience: prevalence and risk factors in a national sample. Birth. 2004;31(1):17–27.CrossRef
5.
go back to reference Smarandache A, Kim TH, Bohr Y, Tamim H. Predictors of a negative labour and birth experience based on a national survey of Canadian women. BMC Pregnancy Childbirth. 2016;16(1):114.CrossRef Smarandache A, Kim TH, Bohr Y, Tamim H. Predictors of a negative labour and birth experience based on a national survey of Canadian women. BMC Pregnancy Childbirth. 2016;16(1):114.CrossRef
6.
go back to reference Soet JE, Brack GA, DiIorio C. Prevalence and predictors of women’s experience of psychological trauma during childbirth. Birth. 2003;30(1):36–46.CrossRef Soet JE, Brack GA, DiIorio C. Prevalence and predictors of women’s experience of psychological trauma during childbirth. Birth. 2003;30(1):36–46.CrossRef
7.
go back to reference Garthus-Niegel S, Knoph C, von Soest T, Nielsen CS, Eberhard-Gran M. The role of labour pain and overall birth experience in the development of posttraumatic stress symptoms: a longitudinal cohort study. Birth. 2014;41:108–15.CrossRef Garthus-Niegel S, Knoph C, von Soest T, Nielsen CS, Eberhard-Gran M. The role of labour pain and overall birth experience in the development of posttraumatic stress symptoms: a longitudinal cohort study. Birth. 2014;41:108–15.CrossRef
8.
go back to reference Elmir R, Schmied V, Wilkes L, Jackson D. Women's perceptions and experiences of a traumatic birth: a meta-ethnography. J Adv Nurs. 2010;66:2142–53.CrossRef Elmir R, Schmied V, Wilkes L, Jackson D. Women's perceptions and experiences of a traumatic birth: a meta-ethnography. J Adv Nurs. 2010;66:2142–53.CrossRef
9.
go back to reference Brown A, Jordan S. Impact of birth complications on breastfeeding duration: an internet survey. J Adv Nurs. 2013;69:828–39.CrossRef Brown A, Jordan S. Impact of birth complications on breastfeeding duration: an internet survey. J Adv Nurs. 2013;69:828–39.CrossRef
10.
go back to reference Ayers S, Eagle A, Waring H. The effects of childbirth-related post-traumatic stress disorder on women and their relationships: a qualitative study. Psychol Health Med. 2006;11:389–98.CrossRef Ayers S, Eagle A, Waring H. The effects of childbirth-related post-traumatic stress disorder on women and their relationships: a qualitative study. Psychol Health Med. 2006;11:389–98.CrossRef
11.
go back to reference Christl B, Reilly N, Smith M, Sims D, Chavasse F, Austin MP. The mental health of mothers of unsettled infants: is there value in routine psychosocial assessment in this context? Arch Womens Ment Health. 2013;16(5):391–9.CrossRef Christl B, Reilly N, Smith M, Sims D, Chavasse F, Austin MP. The mental health of mothers of unsettled infants: is there value in routine psychosocial assessment in this context? Arch Womens Ment Health. 2013;16(5):391–9.CrossRef
12.
go back to reference Gürber S, Bielinski-Blattmann D, Lemola S, Jaussi C, von Wyl A, Surbek D, et al. Maternal mental health in the first 3-week postpartum: the impact of caregiver support and the subjective experience of childbirth–a longitudinal path model. J Psychosom Obstet Gynecol. 2012;33(4):176–84.CrossRef Gürber S, Bielinski-Blattmann D, Lemola S, Jaussi C, von Wyl A, Surbek D, et al. Maternal mental health in the first 3-week postpartum: the impact of caregiver support and the subjective experience of childbirth–a longitudinal path model. J Psychosom Obstet Gynecol. 2012;33(4):176–84.CrossRef
13.
go back to reference Schytt E, Waldenström U. Risk factors for poor self-rated health in women at 2 months and 1 year after childbirth. J Women's Health. 2007;16(3):390–405.CrossRef Schytt E, Waldenström U. Risk factors for poor self-rated health in women at 2 months and 1 year after childbirth. J Women's Health. 2007;16(3):390–405.CrossRef
14.
go back to reference Gottvall K, Waldenstrom U. Does a traumatic birth experience have an impact on future reproduction? BJOG. 2002;109:254–60.CrossRef Gottvall K, Waldenstrom U. Does a traumatic birth experience have an impact on future reproduction? BJOG. 2002;109:254–60.CrossRef
15.
go back to reference Storksen HT, Garthus-Niegel S, Adams SS, Vangen S, Eberhard-Gran M. Fear of childbirth and elective caesarean section: a population-based study. BMC Pregnancy Childbirth. 2015;15:221.CrossRef Storksen HT, Garthus-Niegel S, Adams SS, Vangen S, Eberhard-Gran M. Fear of childbirth and elective caesarean section: a population-based study. BMC Pregnancy Childbirth. 2015;15:221.CrossRef
16.
go back to reference Ayers S, Bond R, Bertullies S, Wijma K. The aetiology of post-traumatic stress following childbirth: a meta-analysis and theoretical framework. Psychol Med. 2016;46(6):1121–34.CrossRef Ayers S, Bond R, Bertullies S, Wijma K. The aetiology of post-traumatic stress following childbirth: a meta-analysis and theoretical framework. Psychol Med. 2016;46(6):1121–34.CrossRef
17.
go back to reference Henriksen L, Grimsrud E, Schei B, Lukasse M. Bidens study group. Factors related to a negative birth experience–a mixed methods study. Midwifery. 2017;51:33–9.CrossRef Henriksen L, Grimsrud E, Schei B, Lukasse M. Bidens study group. Factors related to a negative birth experience–a mixed methods study. Midwifery. 2017;51:33–9.CrossRef
18.
go back to reference Berg M, Lundgren I, Lindmark G. Childbirth experience in women at high risk: is it improved by use of a birth plan? J Perinat Educ. 2003;12(2):1–15.CrossRef Berg M, Lundgren I, Lindmark G. Childbirth experience in women at high risk: is it improved by use of a birth plan? J Perinat Educ. 2003;12(2):1–15.CrossRef
19.
go back to reference Andersen LB, Melvaer LB, Videbech P, Lamont RF, Joergensen JS. Risk factors for developing post-traumatic stress disorder following childbirth: a systematic review. Acta Obstet Gynecol Scand. 2012;91(11):1261–72.CrossRef Andersen LB, Melvaer LB, Videbech P, Lamont RF, Joergensen JS. Risk factors for developing post-traumatic stress disorder following childbirth: a systematic review. Acta Obstet Gynecol Scand. 2012;91(11):1261–72.CrossRef
20.
go back to reference van Son M, Verkerk G, van der Hart O, Komproe I, Pop V. Prenatal depression, mode of delivery and perinatal dissociation as predictors of postpartum posttraumatic stress: an empirical study. Clin Psychol Psychother: An International Journal of Theory & Practice. 2005;12(4):297–312.CrossRef van Son M, Verkerk G, van der Hart O, Komproe I, Pop V. Prenatal depression, mode of delivery and perinatal dissociation as predictors of postpartum posttraumatic stress: an empirical study. Clin Psychol Psychother: An International Journal of Theory & Practice. 2005;12(4):297–312.CrossRef
21.
go back to reference Tani F, Castagna V. Maternal social support, quality of birth experience, and post-partum depression in primiparous women. J Matern Fetal Neonatal Med. 2017;30(6):689–92.CrossRef Tani F, Castagna V. Maternal social support, quality of birth experience, and post-partum depression in primiparous women. J Matern Fetal Neonatal Med. 2017;30(6):689–92.CrossRef
22.
go back to reference Bryanton J, Gagnon AJ, Johnston C, Hatem M. Predictors of women’s perceptions of the childbirth experience. J Obstet Gynecol Neonatal Nurs. 2008;37(1):24–34.CrossRef Bryanton J, Gagnon AJ, Johnston C, Hatem M. Predictors of women’s perceptions of the childbirth experience. J Obstet Gynecol Neonatal Nurs. 2008;37(1):24–34.CrossRef
23.
go back to reference Lupton D. Risk and sociocultural theory: new directions and perspectives. Cambridge University press, Cambridge, United Kingdom. Lupton D. Risk and sociocultural theory: new directions and perspectives. Cambridge University press, Cambridge, United Kingdom.
24.
go back to reference Lewallen LP. The importance of culture in childbearing. J Obstet Gynecol Neonatal Nurs. 2011;40:4–8.CrossRef Lewallen LP. The importance of culture in childbearing. J Obstet Gynecol Neonatal Nurs. 2011;40:4–8.CrossRef
25.
go back to reference Kaphle S, Hancock H, Newman LA. Childbirth traditions and cultural perceptions of safety in Nepal: critical spaces to ensure the survival of mothers and newborns in remote mountain villages. Midwifery. 2013;29(10):1173–81.CrossRef Kaphle S, Hancock H, Newman LA. Childbirth traditions and cultural perceptions of safety in Nepal: critical spaces to ensure the survival of mothers and newborns in remote mountain villages. Midwifery. 2013;29(10):1173–81.CrossRef
26.
go back to reference Dencker A, Taft C, Bergqvist L, Lilja H, Berg M. Childbirth experience questionnaire (CEQ): development and evaluation of a multidimensional instrument. BMC Pregnancy and Childbirth. 2010;10(81):1–8. Dencker A, Taft C, Bergqvist L, Lilja H, Berg M. Childbirth experience questionnaire (CEQ): development and evaluation of a multidimensional instrument. BMC Pregnancy and Childbirth. 2010;10(81):1–8.
27.
go back to reference Rijnders M, Baston H, Schönbeck Y, Van Der Pal K, Prins M, Green J, Buitendijk S. Perinatal factors related to negative or positive recall of birth experience in women 3 years postpartum in the Netherlands. Birth. 2008;35(2):107–16.CrossRef Rijnders M, Baston H, Schönbeck Y, Van Der Pal K, Prins M, Green J, Buitendijk S. Perinatal factors related to negative or positive recall of birth experience in women 3 years postpartum in the Netherlands. Birth. 2008;35(2):107–16.CrossRef
28.
go back to reference EURO-PERISTAT Project with SCPE and EUROCAT. European Perinatal Health Report. The health and care of pregnant women and babies in Europe in 2010. May 2013. Available from: www.europeristat.com. EURO-PERISTAT Project with SCPE and EUROCAT. European Perinatal Health Report. The health and care of pregnant women and babies in Europe in 2010. May 2013. Available from: www.​europeristat.​com.
29.
go back to reference Rasouli M, Keramat A, Khosravi A, Mohabatpour Z. Prevalence and factors associated with episiotomy in Shahroud City, northeast of Iran. Int J Womens Health Reprod Sci. 2016;4(3):125–9.CrossRef Rasouli M, Keramat A, Khosravi A, Mohabatpour Z. Prevalence and factors associated with episiotomy in Shahroud City, northeast of Iran. Int J Womens Health Reprod Sci. 2016;4(3):125–9.CrossRef
30.
go back to reference National Board of Health and Welfare. Official statistics of Sweden. Statistics – health and medical care. Pregnancies, deliveries and newborn infants. The Swedish Medical Birth Register. 2013:1973–2012. National Board of Health and Welfare. Official statistics of Sweden. Statistics – health and medical care. Pregnancies, deliveries and newborn infants. The Swedish Medical Birth Register. 2013:1973–2012.
31.
go back to reference Bernitz S, Øian P, Rolland R, Sandvik L, Blix E. Oxytocin and dystocia as risk factors for adverse birth outcomes: a cohort of low-risk nulliparous women. Midwifery. 2014;30(3):364–70.CrossRef Bernitz S, Øian P, Rolland R, Sandvik L, Blix E. Oxytocin and dystocia as risk factors for adverse birth outcomes: a cohort of low-risk nulliparous women. Midwifery. 2014;30(3):364–70.CrossRef
32.
go back to reference Jardim DMB, Modena CM. Obstetric violence in the daily routine of care and its characteristics. Revista latino-americana de enfermagem. 2018;26:e3069.CrossRef Jardim DMB, Modena CM. Obstetric violence in the daily routine of care and its characteristics. Revista latino-americana de enfermagem. 2018;26:e3069.CrossRef
34.
go back to reference Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A. Continuous support for women during childbirth. Cochrane Database Sys Rev. 2017;7. Bohren MA, Hofmeyr GJ, Sakala C, Fukuzawa RK, Cuthbert A. Continuous support for women during childbirth. Cochrane Database Sys Rev. 2017;7.
35.
go back to reference Gau ML, Chang CY, Tian SH, Lin KC. Effects of birth ball exercise on pain and self-efficacy during childbirth: a randomised controlled trial in Taiwan. Midwifery. 2011;27(6):e293–300.CrossRef Gau ML, Chang CY, Tian SH, Lin KC. Effects of birth ball exercise on pain and self-efficacy during childbirth: a randomised controlled trial in Taiwan. Midwifery. 2011;27(6):e293–300.CrossRef
36.
go back to reference Larsson C, Saltvedt S, Edman G, Wiklund I, Andolf E. Factors independently related to a negative birth experience in first-time mothers. Sex Reprod Healthc. 2011;2(2):83–9.CrossRef Larsson C, Saltvedt S, Edman G, Wiklund I, Andolf E. Factors independently related to a negative birth experience in first-time mothers. Sex Reprod Healthc. 2011;2(2):83–9.CrossRef
38.
go back to reference Gibbins J, Thomson AM. Women's expectations and experiences of childbirth. Midwifery. 2001;17:302–13.CrossRef Gibbins J, Thomson AM. Women's expectations and experiences of childbirth. Midwifery. 2001;17:302–13.CrossRef
39.
go back to reference Lally JE, Murtagh MJ, Macphail S, Thomson R. More in hope than expectation: a systematic review of women's expectations and experience of pain relief in labour. BMC Med. 2008;6(1):7.CrossRef Lally JE, Murtagh MJ, Macphail S, Thomson R. More in hope than expectation: a systematic review of women's expectations and experience of pain relief in labour. BMC Med. 2008;6(1):7.CrossRef
40.
go back to reference Lundgren I, Dahlberg K. Women's experience of pain during childbirth. Midwifery. 1998;14:105–10.CrossRef Lundgren I, Dahlberg K. Women's experience of pain during childbirth. Midwifery. 1998;14:105–10.CrossRef
41.
go back to reference Hidaka R, Callister LC. Giving birth with epidural analgesia: the experience of first-time mothers. J Perinat Educ. 2012;21(1):24–35.CrossRef Hidaka R, Callister LC. Giving birth with epidural analgesia: the experience of first-time mothers. J Perinat Educ. 2012;21(1):24–35.CrossRef
42.
go back to reference Lindholm A, Hildingsson I. Women's preferences and received pain relief in childbirth–a prospective longitudinal study in a northern region of Sweden. Sexual & Reproductive Healthcare. 2015;6(2):74–81.CrossRef Lindholm A, Hildingsson I. Women's preferences and received pain relief in childbirth–a prospective longitudinal study in a northern region of Sweden. Sexual & Reproductive Healthcare. 2015;6(2):74–81.CrossRef
43.
go back to reference Pazandeh F, Potrata B, Huss R, Hirst J, House A. Women’s experiences of routine care during labour and childbirth and the influence of medicalisation: a qualitative study from Iran. Midwifery. 2017;53:63–70.CrossRef Pazandeh F, Potrata B, Huss R, Hirst J, House A. Women’s experiences of routine care during labour and childbirth and the influence of medicalisation: a qualitative study from Iran. Midwifery. 2017;53:63–70.CrossRef
44.
go back to reference Rouhe H, Salmela-Aro K, Gissler M, Halmesmäki E, Saisto T. Mental health problems common in women with fear of childbirth. BJOG. 2011;118:1104–11.CrossRef Rouhe H, Salmela-Aro K, Gissler M, Halmesmäki E, Saisto T. Mental health problems common in women with fear of childbirth. BJOG. 2011;118:1104–11.CrossRef
45.
go back to reference Rouhe H, Salmela-Aro K, Toivanen R, Tokola M, Halmesmäki E, Ryding EL, Saisto T. Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience–a randomised controlled trial. J Psychosom Obstet Gynecol. 2015;36(1):1–9.CrossRef Rouhe H, Salmela-Aro K, Toivanen R, Tokola M, Halmesmäki E, Ryding EL, Saisto T. Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience–a randomised controlled trial. J Psychosom Obstet Gynecol. 2015;36(1):1–9.CrossRef
Metadata
Title
Predictors of traumatic birth experience among a group of Iranian primipara women: a cross sectional study
Authors
Solmaz Ghanbari-Homayi
Zahra Fardiazar
Shahla Meedya
Sakineh Mohammad-Alizadeh-Charandabi
Mohammad Asghari-Jafarabadi
Eesa Mohammadi
Mojgan Mirghafourvand
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2019
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-019-2333-4

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