Negative emotions, childbirth pain, perinatal dissociation and self-efficacy as predictors of postpartum posttraumatic stress symptoms

Objective: The aim of the study was to assess the contribution of negative emotions, childbirth pain, perinatal dissociation, and feelings of self-efficacy to the development of posttraumatic stress disorder (PTSD) symptoms following childbirth. Patients and methods: A prospective longitudinal study was carried out on 98 women from the south of France area. Four questionnaires were completed at 2-3 days postpartum: the Peritraumatic Emotions List (PEL), the French version of the McGill Pain Questionnaire, the Peritraumatic Dissociative Experience Questionnaire (PDEQ) and the Childbirth Self-efficacy Inventory (CBSEI). The Impact of Event Scale-Revised (IES-R) assessing posttraumatic stress symptoms was also completed 6 weeks after delivery. Results: Pain and negative emotions were significant predictors of the intensity of posttraumatic stress symptoms at 6 weeks postpartum. Although higher levels of pain contribute to increased PSTD symptoms, and higher negative emotion also contributes to PTSD symptoms, the effect of pain on PSTD is stronger when there are high levels of negative emotion. Discussion and conclusion: Our findings highlight that pain, negative emotions and their interaction were significant predictors of posttraumatic stress symptoms and confirm the importance of developing more specific treatments focusing on support and prevention.