Negatiivinen synnytyskokemus ja synnytykseen liittyvä traumaperäinen stressihäiriö
Year: 2026
Type: dissertation
Study design: Observational Study
Abstract: Perinatal mental health difficulties are common during pregnancy and after childbirth and may have long-lasting consequences for women, children, and families. Childbirth experience is an important determinant of maternal wellbeing and a key indicator of the quality of maternity care. Mental health and childbirth experience are closely interconnected: psychological difficulties may negatively influence childbirth experience, while a negative childbirth experience may increase the risk of subsequent mental health problems. Childbirth experiences range from positive and empowering to negative and traumatic. At the severe end of this spectrum is childbirth-related post-traumatic stress disorder (CB-PTSD). However, it is still unclear which women develop CB-PTSD and how effectively the condition is identified in healthcare. This doctoral thesis investigated risk factors for negative childbirth experiences and CB-PTSD, as well as approaches for their identification in clinical practice. The research was based on survey data from more than 3800 pregnant women and 3200 partners, linked with national health registers. Postpartum outcomes were examined in a follow-up sample of 1,527 women. Mental health symptoms were common during pregnancy. Eight percent of women reported depressive symptoms, 17% fear of childbirth, and 20% post-traumatic stress symptoms. Partners’ mental health difficulties were associated with similar symptoms among women, highlighting the importance of family wellbeing during the perinatal period. The strongest predictors of a negative childbirth experience were fear of childbirth and unmet expectations. Women’s perceptions of intrapartum care and safety also played a central role, whereas many medical and socioeconomic factors had a smaller impact. Between 9% and 15% of women reported a negative childbirth experience. Negative childbirth experience was the most important risk factor for CB-PTSD. Approximately 6% of women met criteria for partial CB-PTSD and 1% for full CB-PTSD after childbirth. CB-PTSD often remains unrecognized in healthcare services. Assessing childbirth experience both before hospital discharge and several months postpartum may help identify women at increased risk of CB-PTSD. A simple visual analogue scale (VAS) proved useful for this purpose. These findings support the development of clinical practices that promote early recognition of negative and traumatic childbirth experiences and facilitate timely support, thereby improving maternal and family wellbeing.
Source: Työväentutkimus Vuosikirja
Author: Mäkelä, Tia
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7213680547