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Exploring birth trauma and health outcomes of women in the early postnatal period (#60)

Julie Jomeen 1 , Kathleen Baird 2 , Deborah Fox 2 , Elaine Jefford 3 , Annette Briley 4 , Annabel Sheehy 2 , Julia Marsden 1 , Valerie Slavin 5 , Shannon Everest 1 , Rachael Woodworth 2
  1. Southern Cross University, Bilinga, Queensland, Australia
  2. University of Technology Sydney, Sydney, NSW, Australia
  3. University of Sunshine Coast, Sippy Downs, QLD, Australia
  4. Flinders University, Adelaide, Australia
  5. Gold Coast University Hospital, Gold Coast, Qld

Background:

Prevalence rates of birth trauma (BT) is 10-44% (Pidd et al., 2023). Almost 300,000 Australian women give birth annually, with data suggesting 33% will experience BT symptoms (Creedy and Gamble 2018). The incidence of Australian BT has not been conclusive; meta-analysis suggests prevalence of childbirth induced Post Traumatic Stress Disorder (PTSD) is 4.7-12.3% (Heyne et al 2022).

Aims

The primary objective was to undertake INTERSECT (International Survey on Childbirth-related Trauma) in Australia. The Australian INTERSECT study is focused on prevalence of BT/PTSD in Australia, and obtaining Australian data on tokophobia, intimate partner violence and discrimination. This presentation will focus on BT/PTSD on health outcomes for Australian women, in the early postnatal period.

Methods

A cross-sectional online questionnaire, administered 6-12 weeks postpartum, for women >16 in Queensland, New South Wales, and South Australia. The survey included measures of obstetric details, birth satisfaction, BT, PTSD, depression and trauma history. The Australian questionnaire also assessed fear of childbirth (FoB)/tokophobia (TSS), intimate partner violence (IPV), and discrimination. Ethical approval was given by HREC of Western Sydney Local Health District.

Results

To date, 483 women have completed the survey from QLD (45.3%), NSW (27.3%), and SA (27.4%). Of this, 39.3% had a vaginal birth, 28.1% elective caesarean, 19.5% emergency caesarean and 13.1% assisted. Overall, 34.8% reported birth as moderately traumatic, 2.9% extremely traumatic, and 25.1% not traumatic. Maternal birth complications associated with more birth trauma, compared to minor/no complications (p ≤ .001). Women with moderately/extremely traumatic birth had higher FoB/TSS (p ≤ .001). depression (p ≤ .001), and PTSD (p ≤ .001), compared to women with mild/no trauma. 

Discussion

BT is largely in line with previous findings, and associated with adverse physical and mental health outcomes for Australian women. Further interrogation of the Queensland data will reveal insights for Queensland women.  

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