Determinants of Postpartum Post-traumatic Stress Disorder: A Cross-Sectional Study

Objectives: Postpartum post-traumatic stress disorder (PTSD) is regarded as a life-threatening childbirth experience for mother or infant and may be accompanied with the risk of death or serious injury to the mother or her infant. Given the changes to diagnostic criteria of traumatic childbirth brought in with DSM-5 and considering the unfavorable outcomes of postpartum PTSD, this study was carried out to identify the determinants of postpartum PTSD. Materials and Methods: This cross-sectional study was conducted in 2018 on 310 postpartum women who had experienced a traumatic childbirth, based on the DSM-5 criteria, and referred to Tabriz health centers for routine care 42-60 days after the delivery. Subjects were selected through convenience sampling. Research instruments were demographic, obstetric, and neonatal information questionnaire, Post-Traumatic Stress Checklist for DSM-5 Criteria (PCL-5), Mackey Childbirth Satisfaction Rating Scale, and Winefield and Tiggemann Social Support Questionnaire. The data were analyzed using SPSS version 25.0, and ANOVA, independent t-test, Pearson correlation coefficient test, Spearman correlation coefficient test, and multivariate linear regression were applied. Results: The mean score (+/- standard deviation) of postpartum PTSD was 42.13 (+/- 11.72). The determinants of postpartum PTSD also included complications during pregnancy, type of delivery, concordance between desired and actual type of delivery, method of placenta removal, analgesia, sleeping and neonatal states, satisfaction with childbirth, and perceived support during and after childbirth. Conclusions: Designing interventions to make childbirth more pleasant through provision of methods for a pain-free or pain-reduced childbirth, promotion of satisfaction with childbirth, and support during and after the childbirth seem to be essential for reducing postpartum PTSD.