Mistreatment and Discrimination during Childbirth, Associations with Symptoms of Childbirth-Related Posttraumatic Stress Disorder and the Mediating Role of the Subjective Birth Experience: A Quantitative Analysis Within the Prospective Cohort Study RESPECTPARENTS

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Contributors

Abstract

Background Mistreatment and discrimination during childbirth are a global public health concern. Such experiences can adversely affect the subjective birth experience and increase the likelihood of compromised postpartum mental health, including symptoms of childbirth-related posttraumatic stress disorder (CB-PTSD) not only in mothers/birthing parents, but also in partners. This study examines instances of mistreatment and discrimination during childbirth, their association with CB-PTSD symptoms, and the potential mediating role of the subjective birth experience in both parents. Methods Data were retrieved from the prospective RESPECTPARENTS cohort, a German community sample. For the current study, data from n = 1075 mothers/birthing parents and n = 454 partners, collected at two assessment points, i.e., during pregnancy and eight weeks after birth, were included. Regression and mediation models were used to analyze the associations separately for mothers/birthing parents and partners. Results Mistreatment during childbirth was reported by 25.8 % of mothers/birthing parents and 6.8 % of partners, whereas perceived discrimination was reported by 3.9 % of mothers/ birthing parents and 3.5 % of partners. These experiences predicted more severe CB-PTSD symptoms among mothers/ birthing parents. For both parents, experiencing more mistreatment and more discrimination was associated with a more negative subjective birth experience, which in turn was associated with more severe CB-PTSD symptoms, demonstrating a significant mediation effect. Conclusion The current study indicates that mistreatment and discrimination during childbirth exist in Germany among both mothers/birthing parents and partners, potentially contributing to a more negative subjective birth experience and more severe CB-PTSD symptoms. The findings emphasize the need to address mistreatment and discrimination during childbirth for both parents, in general and as potential risk factors for adverse outcomes.

Details

Original languageEnglish
JournalGeburtshilfe und Frauenheilkunde
Publication statusE-pub ahead of print - Nov 2025
Peer-reviewedYes

Keywords

Keywords

  • CB-PTSD symptoms, discrimination, obstetric violence/mistreatment, RESPECT study, subjective birth experience