Mediating role of childbirth readiness in the relationship between social support and psychological birth trauma in primiparous women: a nationwide cross-sectional study in China

Objective To examine the relationship between social support and psychological birth trauma among Chinese primiparous women and the mediating effects of childbirth readiness. Design A cross-sectional study was conducted between November 2021 and March 2022. Setting 10 general tertiary hospitals and 3 specialised maternity hospitals in 7 provinces in China. Participants A total of 751 primiparous women were recruited for this study. Outcome measures The questionnaires consisted of questions on demographic characteristics, the Birth Trauma Scale, the Chinese Mandarin version of the Medical Outcomes Study Social Support Survey and the Childbirth Readiness Scale. Hierarchical multiple regression was used to explore the associated factors and mediating role of childbirth readiness in the relationship between social support and psychological birth trauma. The mediating model was examined by the PROCESS macro for SPSS. Results After adjusting for demographic variables, social support was negatively associated with psychological birth trauma (r=-0.242, p<0.01). Childbirth readiness had a positive correlation with social support (r=0.206, p<0.01) and a negative correlation with psychological birth trauma (r=-0.351, p<0.01). The hierarchical multiple regression model indicated that social support and childbirth readiness explained 3.9% and 7.7% of the variance in psychological birth trauma, respectively. Childbirth readiness partly mediated the association between social support and psychological birth trauma for primiparas. Conclusions Childbirth readiness plays a mediating role between social support and psychological birth trauma among primiparas. Strategies and interventions to enhance childbirth readiness levels may be expected to improve the impact of social support on women's psychological birth trauma.