Oxford Health NHS Foundation Trust, Warneford Hospital, Warneford Lane, OX3 7JX, Oxford, UK.
Oxford Institute of Clinical Psychology Training and Research, Isis Education Centre, University of Oxford, Warneford Hospital, Warneford Lane, OX3 7JX, Oxford, UK.
BMC Pregnancy Childbirth. 2024 Jun 21;24(1):437. doi: 10.1186/s12884-024-06288-3.
Experiencing childbirth as traumatic is common and can have long-lasting negative consequences for women's mental health. However, fostering a sense of social identity has been shown to protect psychological wellbeing and mental health during life transitions, such as entering parenthood. This study therefore investigated the relationship between traumatic childbirth and first-time mothers' social identity and their psychological wellbeing, and more specifically whether strength of identity as a first-time mother protected psychological wellbeing following traumatic childbirth.
Women over the age of 18 who were living in the UK and had given birth to their first child in the past nine months were recruited to the study from clinical and community settings. They completed digital self-report questionnaires about their birth experience, social identity, mental health, and psychological wellbeing. Women who perceived themselves to have had a traumatic birth (the trauma group; N = 84) were compared to women who did not perceive themselves to have had a traumatic birth (the control group, N = 39). T-tests and chi square tests assessed preliminary group differences before multivariate analyses of covariance controlled for covariates. Post-hoc tests identified the direction of differences. Multiple regression and moderation analyses analysed interaction effects.
The trauma group had significantly lower psychological wellbeing (mean = 41.5, 95% CI [39.4-43.7], p = .008, partial η = 0.059), compared to the control group (mean = 48.4, 95% CI [45.3-51.5]), but the two groups did not differ in the strength of their first-time mother identity, which was high across both groups. Strength of identity did not moderate the relationship between traumatic childbirth and psychological wellbeing. Giving birth by caesarean section independently reduced the strength of the first-time mother identity (p = .017, partial η = 0.049). All analyses controlled for emotional and practical support, perceptions of healthcare staff, and mode of birth.
Having a traumatic birth was associated with lower psychological wellbeing, and the strength of first-time mother identity does not appear to moderate this relationship. Factors such as mode of birth may be more important. Further research, including longitudinal designs, is needed to understand the relationship between these constructs and identify more effective ways of protecting first-time mothers' mental health.
分娩经历被视为创伤是很常见的，这可能会对女性的心理健康产生长期的负面影响。然而，在生活过渡期间，如成为父母，培养社会认同感已被证明可以保护心理幸福感和心理健康。因此，本研究调查了创伤性分娩与初产妇的社会认同感和心理幸福感之间的关系，更具体地说，是初产妇的身份认同感是否能在创伤性分娩后保护其心理幸福感。
从临床和社区环境中招募了年龄在 18 岁以上、过去 9 个月内分娩过第一胎的英国女性参与本研究。她们完成了关于分娩经历、社会认同感、心理健康和心理幸福感的数字自我报告问卷。将认为自己分娩经历是创伤性的女性（创伤组；n=84）与认为自己分娩经历不是创伤性的女性（对照组，n=39）进行比较。在控制协变量的多变量协方差分析之前，t 检验和卡方检验评估了初步的组间差异。事后检验确定了差异的方向。多元回归和调节分析分析了交互作用。
创伤组的心理幸福感显著较低（平均=41.5，95%置信区间[39.4-43.7]，p=0.008，部分η=0.059），与对照组（平均=48.4，95%置信区间[45.3-51.5]）相比，而两组在初产妇身份认同感方面没有差异，两组的身份认同感都很高。身份认同感并没有调节创伤性分娩与心理幸福感之间的关系。剖腹产分娩独立降低了初产妇身份认同感（p=0.017，部分η=0.049）。所有分析均控制了情感和实际支持、医护人员的看法以及分娩方式。
创伤性分娩与较低的心理幸福感相关，而初产妇身份认同感似乎并不能调节这种关系。分娩方式等因素可能更为重要。需要进一步的研究，包括纵向设计，以了解这些结构之间的关系，并确定更有效的保护初产妇心理健康的方法。
