| Abstract [eng] |
Birth as traumatic experience and mental health of postpartum women in recent years are becoming subject of multidisciplinary research. This interdisciplinary study in the fields of social work and medicine focuses on a previously unexplored group, i.e., socially vulnerable women, whose experiences and the underlying causes in some cases are significantly more adverse. The theoretical background is based on Urie Bronfenbrenner’s bioecological model of human development. Quantitative research methods were used in empirical part of the study. From the overall sample of the study, which included 1,471 women who gave birth in Lithuania in 2023 and participated in the survey “Mano Gimdymas”, 316 respondents experiencing social vulnerability were identified. The study examines the prevalence of traumatic birth experiences, postpartum depression, and post-traumatic stress disorder within the aforementioned group. The research problem lies in exploring the relationships between various aspects of the birth experience, general women's evaluation of that experience, and their postpartum emotional health. Potentially significant factors influencing the birth experience were selected for analysis based on findings reported in the scientific literature and data collected during the survey. Birth experiences were subjectively assessed by the respondents. To determine the prevalence of depression, the Edinburgh Postnatal Depression Scale (EPDS) was used, while the Trauma Screening Questionnaire (TSQ) was applied to assess post-traumatic stress disorder (PTSD). A traumatic birth experience was reported by 21% of the respondents. Postpartum depression was suspected in 30%, and PTSD symptoms were identified in 10% of socially vulnerable women. All of these rates are significantly higher compared to the overall sample. The study found that several factors had a statistically significant impact on all investigated outcomes. These included experiences of abuse and/or disrespect from medical staff during childbirth, unmet expectations, lack of trust in medical professionals’ competence, use of medical pain relief, restricted mobility, and place of birth. The perception of childbirth as a traumatic experience was also significantly associated with non-recommended practices such as the use of the Kristeller maneuver, separation of the newborn, cesarean delivery, medical interventions, exclusion from decision-making during childbirth, and pregnancy-related risk factors. The risk of postpartum depression was also significantly increased by poor communication from medical staff. The prevalence of PTSD was also significantly influenced by the use of the Kristeller maneuver, a traumatic birth experience, first-time childbirth, cesarean delivery, inadequate staff communication, and risk factors during pregnancy. The study indicates that maternity care services in Lithuania often do not meet women's needs. Psychological trauma is common and can affect not only the well-being of the women themselves but potentially also those of their close environment. The findings underscore the importance of making maternity care more woman-centered — emphasizing the quality of their experiences and strengthening of mental health, particularly among the most vulnerable populations. |
