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探索创伤性分娩:产科暴力指标与围产期创伤后应激之间的关联

Exploring traumatic childbirth: Associations between obstetric violence indicators and perinatal posttraumatic stress.

作者信息

Vega-Sanz Maria, Halty Amaia, Goñi-Dengra Sofía, Pitillas Carlos, Berástegui Ana

机构信息

University Institute of Family Studies, Pontifical Comillas University, Madrid, Spain.

出版信息

PLoS One. 2025 Jun 3;20(6):e0324461. doi: 10.1371/journal.pone.0324461. eCollection 2025.

Abstract

OBJECTIVE

The childbirth experience can be traumatic for women, with negative repercussions on their mental health, mother-child bonding, and subsequent infant development. The aim of this study is to analyze the negative birth experience, through indicators of obstetric violence (OV), as a risk factor for the development of Perinatal Posttraumatic Stress (P-PTS) in early postpartum. Additionally, we seek to explore the buffering impact of other variables on the development of P-PTS symptomatology.

METHODS

A total of 236 postpartum women were surveyed online, between the fourth and sixth week postpartum, assessing thirteen indicators of OV using the Questionnaire on Birth Conditions. We also utilized the Post-traumatic Stress Symptom Checklist and Multidimensional Scale of Perceived Social Support, alongside collecting sociodemographic, pregnancy and delivery conditions. Mean differences, correlations, and regression analyses were performed.

RESULTS

Women exposed to OV have a higher risk of developing P-PTS symptoms. Increased risk was noted in those exposed to staff's ironic comments, undergoing medical procedures without prior information, or those who were made to feel guilty for childbirth outcomes. Moreover, early postpartum skin-to-skin contact and perceived social support from friends and family served as protective factors against P-PTSS development.

CONCLUSIONS

Postpartum traumatization may not solely stem from threats to physical integrity or survival but also from experiences of inferiority, inadequacy, loss of dignity, or dehumanizing treatment. These findings underline the necessity for healthcare professionals to enhance the quality of care during childbirth, to maximize immediate skin-to-skin contact, and been aware and actively seeking social support for women.

摘要

目的

分娩经历对女性来说可能具有创伤性,会对其心理健康、母婴联结及随后的婴儿发育产生负面影响。本研究的目的是通过产科暴力(OV)指标分析负面分娩经历,将其作为产后早期围产期创伤后应激(P-PTS)发展的一个风险因素。此外,我们试图探讨其他变量对P-PTS症状发展的缓冲作用。

方法

在产后第四至六周对总共236名产后女性进行在线调查,使用《出生情况问卷》评估13项OV指标。我们还使用了创伤后应激症状清单和感知社会支持多维量表,同时收集社会人口统计学、妊娠和分娩情况。进行了均值差异、相关性和回归分析。

结果

遭受OV的女性出现P-PTS症状的风险更高。在那些遭受工作人员讽刺性评论、在没有事先告知的情况下接受医疗程序,或那些因分娩结果而感到内疚的女性中,风险增加。此外,产后早期的皮肤接触以及来自朋友和家人的感知社会支持是预防P-PTSS发展的保护因素。

结论

产后创伤可能不仅源于对身体完整性或生存的威胁,还源于自卑、不足、尊严丧失或非人性化待遇的经历。这些发现强调了医疗保健专业人员提高分娩期间护理质量、最大限度地增加即时皮肤接触以及意识到并积极为女性寻求社会支持的必要性。

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