Pathways to Birth Trauma: Prenatal PTSD as a Mediator Between Adverse Childhood Experiences and Childbirth‐Related PTSD Symptoms

Background Extensive research highlights the risk of PTSD following traumatic childbirth. However, PTSD during pregnancy—whether preexisting or emerging prenatally—receives far less attention despite its associated harmful effects on maternal and infant well‐being. To fill this gap, the current study examines predictors of childbirth‐related PTSD symptoms, including maternal ACEs and prenatal PTSD symptoms in 91 mothers from a diverse community sample (47% particpants of c) within the United States. Methods Participants completed questionnaires on ACEs and PTSD symptoms during their third trimester of pregnancy and childbirth‐related PTSD symptoms at 6‐weeks postpartum. The current study used a path analysis model to examine the mediating effects of prenatal PTSD on the relationship between ACEs and childbirth‐related PTSD symptoms at 6‐weeks postpartum. Results Findings indicated that ACEs have implications for childbirth‐related PTSD symptoms at 6‐weeks postpartum with a significant indirect effect through prenatal PTSD, standardized indirect effect = 0.20, 95% CI = [0.02, 0.36], p = 0.03. Conclusion Screening for childhood adversity during pregnancy may have dual benefits for prenatal and postpartum health, such that screening can help identify women at risk for prenatal PTSD as well as those at risk for later childbirth‐related trauma symptoms who may benefit from trauma‐informed targeted prevention and intervention efforts.