Poster #69 - Birth Trauma and Perinatal Bonding: The role of maternal adversity

• In Event: Poster Session 10

Abstract

Background: Birth trauma, the actual or threatened serious injury or death to a birthing person or infant during labor and delivery (Beck, 2004), impacts approximately 35% of birthing persons (Soet et al., 2003). Trauma that is related to pregnancy and childbirth can lead to symptoms consistent with posttraumatic stress disorder (PTSD; Soet et al., 2003), with 3-16% of postpartum birthing persons meeting criteria for PTSD following childbirth (Grekin & O’Hara, 2014). Notably, the implications of birth trauma can persist across the perinatal period and negatively impact bonding during pregnancy and postpartum. Further, emerging literature highlights the role of early life exposure to adversity, like Adverse Childhood Experiences (ACEs), in increasing an individual’s risk of experiencing birth trauma. Thus, examining maternal history of ACEs and factors related to bonding, may provide insight into underlying risk factors affecting birth trauma and mother-infant bonding.

Methods: Fifty-eight birthing persons (referred to as women and mothers in this study based on our sample demographics) from a diverse, community sample (45% white) completed questionnaires on ACEs and maternal-fetal bonding at 30-weeks gestation, as well as measures of birth trauma at 6-weeks postpartum and bonding difficulties at 6-weeks postpartum.

Results: Path analysis using Mplus 8.0 (Muthén & Muthén, 1998-2017) was used to examine the mediating role of maternal birth trauma on the relationship between maternal ACEs and bonding difficulties at 6-weeks postpartum, as well as the moderating role of prenatal bonding on the relationship between maternal ACEs and postpartum bonding difficulties at 6-weeks postpartum. Maternal age, level of education, and depressive symptoms at 6-weeks were included as covariates in the model. Overall, the fit indices for the final model presented in Figure 1 indicated acceptable fit (Hooper et al., 2008; Asparouhov & Muthén, 2018), χ2 = 7.56 (10), p = .67; RMSEA = .00 (90% CI [.00, .11]; CFI = 1.0; and SRMR = .07. The model predicted 65% of the variance in postpartum bonding difficulties at 6-weeks postpartum and 36% of the variance in birth trauma at 6-weeks, according to R2.

Discussion: Results indicated that maternal ACEs have implications for postpartum bonding difficulties at 6-weeks with significant indirect effects through birth trauma at 6-weeks. Further, maternal-fetal bonding moderated the relationship between ACEs and postpartum bonding difficulties at 6-weeks, such that postpartum bonding difficulties are consistently higher at lower levels of maternal-fetal bonding. Results of this study underscore the importance of assessing for maternal ACEs and early detection of maternal-fetal bonding difficulties during pregnancy. Addressing bonding difficulties during pregnancy, particularly among women with high ACEs, may be a target of intervention to reduce birth trauma and improve long-term bonding.

Authors

• Samantha Addante, Oklahoma State University - Stillwater
  Presenting Author

• Gina Erato, Oklahoma State University - Stillwater

• Ashley N Quigley, Oklahoma State University - Stillwater

• Kristin Fields, Oklahoma State University - Stillwater

• Karina M. Shreffler, University of Oklahoma Health Sciences Center

• Lucia Ciciolla, Oklahoma State University - Stillwater