Adverse Childbirth Experiences: Childbirth-Related Post-Traumatic Stress Disorder and the Mother-Infant Relationship

Abstract

Maternal postpartum psychopathology has profound influence on child developmental outcomes. While maternal depression has largely been the focus of this research, an adjacent body of work has focussed on the impact of adverse childbirth experiences on mother and infant outcomes, particularly on the development of maternal childbirth-related post-traumatic stress disorder (CB-PTSD). The overall aim of this thesis was to examine CB-PTSD as it relates to diagnosis and heterogeneity of the disorder, maternal history of adversity and the mother-infant relationship. Study 1 examined the psychometric properties of a measure of a self-report CB-PTSD measure in a population of Australian women (n = 705). Study 2 examined whether meaningful heterogeneity could be identified in CB-PTSD symptom profiles in a cohort of Australian women (n = 816) using cluster-based, person-centred analyses. Study 3 examined the association between maternal CB-PTSD, dimensions of childhood adversity (specifically threat and deprivation-based adversity) and the developmental timing of adversity. This research, based on a community sample of Australian mothers (n = 648), found that maternal CB-PTSD symptoms were associated with threat-based adversity and deprivation-based adversity, and the developmental timing of exposure to adversity yielded further significant results. Study 4 examined the association between CB-PTSD and mother-infant behavioural synchrony in a cohort of Australian mother-infant dyads (n = 110). Mothers were assessed for symptoms of CB-PTSD via clinician-rated diagnostic interview. Observations of mother-infant interactions during play revealed that dyadic behavioural synchrony was lower in dyads with mothers who were experiencing CB-PTSD symptoms at sub-threshold and greater diagnostic levels. These findings support emerging evidence that suggests the conditions of childbirth have a lasting effect on both maternal mental health and the mother-infant dyad.