Childbirth experience, Birth-related posttraumatic stress disorder and their relationship with maternal performance among adolescent mothers reffering to Tabriz health centers: a cross-sectional study

Abstract

bstractTitle: Birth-related posttraumatic stress disorder and negative childbirth experience related to maternal functioning among adolescent mothers: A cross-sectional study.Background and aim: Adolescent pregnancy is an important issue in terms of reproductive health. Adolescent mothers have to overcome two crises at the same time: motherhood and maturity. Childbirth experience and posttraumatic stress disorder may influence the mother's perception of her infant and postpartum care behaviors. Therefore, the aim of the present study was to determine the relationship between childbirth experience and post-traumatic stress disorder with maternal functioning in adolescent mothers in Tabriz.Materials and Methods: This cross-sectional study was conducted on 202 adolescent mothers referring to health centers in Tabriz and its suburbs. Sampling was done by census in the period of 1 to 3 months after delivery. After checking the eligibility of mothers to enter the study, demographic questionnaires, childbirth experience Questionnaire-2 (CEQ 2.0), Post Traumatic Stress Disorder (PTSD) and Barkin's Index of Maternal Functioning (BIMF) were completed. Pearson's correlation, Spearman's correlation, one-way ANOVA, and independent t-test were used to determine the relationship between socio-demographic and obstetrics variables with mother's functioning. In the next step, variables with P-value<0.1 were entered into multivariate analysis and by adjusting the effect of these variables, the relationship between childbirth experience, post-traumatic stress disorder and maternal Functioning was investigated.Results: The mean (Standard Deviation) of the overall maternal Functioning score (score range: 0 to 120) was 86.4 (5.4). The mean (SD) of mother's need and mother's competence subdomains were 14.1 (2.7) (score range: 0 to 18) and 3.72 (3.8) (score range: 0 to 184), respectively. The mean (SD) of the overall score of childbirth experience was 2.7 (0.2) from a possible score of 1 to 4. The prevalence of negative birth experience was 11.4%. The mean (SD) of the overall score of post-traumatic stress disorder related to birth was 4.6 (6.2) from a possible score of 0 to 51. The prevalence of post-traumatic stress disorder related to birth was 18.3%. There was a statistically significant relationship between childbirth experience and post-traumatic stress disorder and its subdomains (p=0.003). After adjusting the effect of socio-demographic and obstetric characteristics, the score of maternal functioning among mothers without posttraumatic stress disorder was statistically significantly higher than mothers with posttraumatic stress disorder diagnosis [β (95% CI) = 2.30 (0.39 to 4.20); p=0.031]. The score of maternal functioning increased with the increase in the childbirth experience score [β (95% CI) = 7.34 (3.87 to 10.81); p<0.001]. The score of maternal functioning among mothers with wanted sex of fetal was statistically significantly higher than unwanted sex of fetal [β (95% CI) = 2.70 (0.37 to 5.02); p=0.023].Conclusion: According to the findings of this study, the post-traumatic stress disorder score related to childbirth and the childbirth experience of adolescent mothers have a positive correlation with the maternal functioning score. Healthcare professionals should pay special attention to improving maternal functioning among adolescent mothers. One of the important actions can be to create a positive experience of childbirth for avoiding of posttraumatic stress disorder following birth and counseling with mothers who stated sex of fetus is undesired.