Traumatic Childbirth During COVID-19 Can Trigger Psychological Growth
Key findings
- This study examined the effects of traumatic childbirth during COVID-19 on maternal psychological health and mother–infant bonding
- 544 participants who gave birth before the pandemic and 2,205 who gave birth after its outbreak completed a survey between April 2 and December 31, 2020
- No differences in the prevalence of post-traumatic growth were noted between the groups who delivered before versus after COVID-19
- However, in deliveries during the pandemic, and not in deliveries before the pandemic, acute stress in childbirth was associated with significant post-traumatic growth
- During the pandemic (only), post-traumatic growth was associated with significantly lower post-traumatic stress symptoms and significantly better mother–infant bonding
The term "post-traumatic growth" refers to a phenomenon in which some individuals experience positive psychological changes due to emotional struggle related to an acutely stressful event. Post-traumatic growth has been repeatedly documented in individuals who faced various forms of traumatic events, but less is known about the experience of psychological growth resulting from childbirth (see the report in Archives of Women's Mental Health).
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Mrithula S. Babu, a research student in the Dekel Laboratory at Massachusetts General Hospital, Sharon Dekel, PhD, principal investigator and director of the Lab in the Department of Psychiatry, and colleagues have found that traumatic childbirth during COVID-19 can trigger post-traumatic growth—which can, in turn, can promote positive postpartum adjustment. Their findings appear in the Journal of Affective Disorders.
Methods
From April 2 to December 31, 2020, the researchers conducted an anonymous survey to understand the impact of COVID-19 on maternal wellness. The current analysis included 544 participants who gave birth before the pandemic and 2,205 who gave birth after its outbreak. All were ≥18 years old and delivered a live baby within six months before responding to the survey.
On average, the participants were 32 years old and 2 months postpartum at the time of the survey. Most had a vaginal delivery (71%), gave birth at term to a healthy infant (93%), and were primiparas (55%). They completed four self-report measures:
- Post-traumatic Growth Inventory–Expanded (PTGI-X) (25 items scored 0–5)
- Peritraumatic Distress Inventory
- PTSD Checklist for DSM-5
- Maternal Attachment Inventory
Results
34% of the sample reported some degree of growth as a result of childbirth (PTGI-X score between 25 and 50) and 26% indicated more substantial growth (PTGI-X score >50). The most common endorsed items were:
- Appreciation for life (64%)
- Personal strength (54%)
- Relating to others (48%)
- New possibilities (37%)
- Spiritual and existential change (24%)
No differences in the prevalence of post-traumatic growth were noted between the groups who delivered before COVID-19 versus during COVID-19. However, in deliveries during the pandemic, and not deliveries before the pandemic:
- Childbirth-related acute stress was linked with elevated post-traumatic growth (β, 0.07; P<0.01)
- Post-traumatic growth was associated with lower posttraumatic stress symptoms (β, −0.06; P<0.05)
- Post-traumatic growth was associated with better mother-infant bonding (β, 0.22; P<0.001)
Conclusion
Targeted interventions to promote psychological growth may benefit women at risk of adverse outcomes after exposure to traumatic childbirth. During COVID-19, this may include, for instance, women whose partners were barred from attending the birth and/or women who were isolated from their infants after delivery.
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