ORIGINAL RESEARCH article
Front. Glob. Womens Health
Sec. Maternal Health
Volume 6 - 2025 | doi: 10.3389/fgwh.2025.1568446
Relationship between the perception of disrespectful treatment and abuse during childbirth and the risk of postpartum post-traumatic stress disorder: a PPQ-based study
Provisionally accepted
Inmaculada Ortiz Esquinas1
Ana Rubio Álvarez2*
Ana Ballesta Castillejos3
Julián Rodríguez Almagro3
Juan Miguel Martínez Galiano4
Antonio Hernández Martínez3- 1Reina Sofia University Hospital, Cordoba, Spain
- 2University Hospital of Torrejón, Torrejón de Ardoz, Spain
- 3Faculty of Nursing, University of Castilla La Mancha, Ciudad Real, Spain
- 4Department of Nursing, Faculty of Health Sciences, University of Jaén, Jaén, Andalusia, Spain
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Problem: Childbirth is often portrayed as a positive and empowering experience, yet for many women, it can result in negative emotional outcomes, which may contribute to the development of postpartum Post-Traumatic Stress Disorder (PTSD). Understanding the association between perceived abuse during childbirth and PTSD is crucial for improving maternal care.Background: Research shows that disrespectful and abusive treatment during childbirth is linked to psychological distress and PTSD. However, the correlation between perceived abuse and PTSD in postpartum women remains underexplored.To determine the association between the woman's perception of abuse during childbirth and the risk of developing PTSD postpartum, as well as to analyze related risk factors.: A cross-sectional observational study was conducted with 2912 women in Spain who gave birth in the last 18 months. The Childbirth Abuse and Respect Evaluation-Maternal Questionnaire (CARE-MQ) assessed perceived abuse, while the Perinatal PTSD Questionnaire (PPQ) measured PTSD risk. Logistic regression was used to adjust for confounders. Findings: Higher CARE-MQ scores were positively correlated with PTSD risk, especially in the "inadequate treatment by professionals" dimension (r = 0.56). Extreme perception of abuse (≥95th percentile) increased the PTSD risk (aOR = 34.72). Additional risk factors included extremely premature birth, unrespected birth plans, complications, type of birth and emergency cesarean sections. Discussion: Perceived mistreatment and inadequate professional care strongly correlate with PTSD risk. Conclusion: Addressing these factors-along with other identified risks-may help reduce PTSD prevalence and improve maternal care experiences.
Keywords: abuse, Obstetric violence, Post-traumatic stress disorder, Postpartum, wome's mental health
Received: 29 Jan 2025; Accepted: 22 Apr 2025.
Copyright: © 2025 Ortiz Esquinas, Rubio Álvarez, Ballesta Castillejos, Rodríguez Almagro, Martínez Galiano and Hernández Martínez. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ana Rubio Álvarez, University Hospital of Torrejón, Torrejón de Ardoz, Spain
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