Maternal and perinatal factors associated with childbirth-related post-traumatic stress symptoms: a cross-sectional study

Objective: The aim of this study was to examine how a set of selected interacting maternal and perinatal clinical characteristics are associated with symptoms of post-traumatic stress after birth. Methods: We conducted a cross-sectional online survey among women between 3 and 18 months after birth. Participants completed self-report measures of post-traumatic stress symptoms and questions regarding clinical variables related to pregnancy, birth and the postnatal period. Statistical models were used to estimate the association between clinical factors and symptom severity. Results: The strongest predictors of elevated post-traumatic stress symptoms were short-term complications like postpartum curettage and the need for hospitalisation due to neonatal health complications. Emergency caesarean section during the first stage of labour was also associated with higher symptom severity, whereas planned caesarean section, postpartum haemorrhage and prolonged postnatal stay were not significantly related to symptoms. Conclusion: These findings highlight the importance of recognizing acute obstetric and neonatal events as relevant factors contributing to post-traumatic stress after birth. They specify that trauma-informed perinatal care must be actively implemented by establishing targeted psychological screening protocols for women experiencing emergency surgical interventions or neonatal separations, and by prioritizing transparent communication and continuous consent during acute obstetric procedures.