背景:经历分娩时的创伤是常见的,并且会对妇女的心理健康产生长期的负面影响。然而,培养社会认同感已被证明可以在生命过渡期间保护心理健康和心理健康,比如进入父母身份。因此,这项研究调查了创伤分娩与初产妇的社会认同及其心理健康之间的关系。更具体地说,作为第一次母亲的身份强度是否保护了创伤性分娩后的心理健康。
方法:从临床和社区环境中招募了18岁以上居住在英国并在过去9个月内生下第一个孩子的女性参与研究。他们完成了关于他们出生经历的数字自我报告问卷,社会认同,心理健康,和心理健康。将认为自己有创伤性分娩的妇女(创伤组;N=84)与没有认为自己有创伤性分娩的妇女(对照组,N=39)。T检验和卡方检验在对协变量进行协方差控制的多变量分析之前评估了初步的组差异。事后测试确定了差异的方向。多元回归和适度分析分析了交互效应。
结果:创伤组的心理健康状况明显较低(平均值=41.5,95%CI[39.4-43.7],p=.008,部分η2=0.059),与对照组相比(平均值=48.4,95%CI[45.3-51.5]),但是两组在第一次母亲身份的强度上没有差异,这两组都很高。身份认同的强度并不能缓解创伤性分娩与心理健康之间的关系。通过剖腹产独立地降低了首次母亲身份的强度(p=.017,部分η2=0.049)。所有为情感和实践支持而控制的分析,对医护人员的看法,和出生模式。
结论:出生创伤与较低的心理健康有关,第一次母亲身份的力量似乎并不能缓和这种关系。出生方式等因素可能更为重要。进一步研究,包括纵向设计,需要了解这些结构之间的关系,并确定更有效的方法来保护初产妇的心理健康。
BACKGROUND: Experiencing childbirth as traumatic is common and can have long-lasting negative consequences for women\'s mental health. However, fostering a sense of social identity has been shown to protect psychological wellbeing and mental health during life transitions, such as entering parenthood. This study therefore investigated the relationship between traumatic childbirth and first-time mothers\' social identity and their psychological wellbeing, and more specifically whether strength of identity as a first-time mother protected psychological wellbeing following traumatic childbirth.
METHODS: Women over the age of 18 who were living in the UK and had given birth to their first child in the past nine months were recruited to the study from clinical and community settings. They completed digital self-report questionnaires about their birth experience, social identity, mental health, and psychological wellbeing. Women who perceived themselves to have had a traumatic birth (the trauma group; N = 84) were compared to women who did not perceive themselves to have had a traumatic birth (the control group, N = 39). T-tests and chi square tests assessed preliminary group differences before multivariate analyses of covariance controlled for covariates. Post-hoc tests identified the direction of differences. Multiple regression and moderation analyses analysed interaction effects.
RESULTS: The trauma group had significantly lower psychological wellbeing (mean = 41.5, 95% CI [39.4-43.7], p = .008, partial η2 = 0.059), compared to the control group (mean = 48.4, 95% CI [45.3-51.5]), but the two groups did not differ in the strength of their first-time mother identity, which was high across both groups. Strength of identity did not moderate the relationship between traumatic childbirth and psychological wellbeing. Giving birth by caesarean section independently reduced the strength of the first-time mother identity (p = .017, partial η2 = 0.049). All analyses controlled for emotional and practical support, perceptions of healthcare staff, and mode of birth.
CONCLUSIONS: Having a traumatic birth was associated with lower psychological wellbeing, and the strength of first-time mother identity does not appear to moderate this relationship. Factors such as mode of birth may be more important. Further research, including longitudinal designs, is needed to understand the relationship between these constructs and identify more effective ways of protecting first-time mothers\' mental health.