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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 RESPECT (PARENTS)
#MMPMID41347055
Porstendorfer-Almeida Froz C
; Vollert B
; Hansen I
; Schurig N
; Seefeld L
; Weise V
; Birdir C
; Wimberger P
; Garthus-Niegel S
Geburtshilfe Frauenheilkd
2025[Dec]; 85
(12
): 1304-1325
PMID41347055
show ga
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
RESPECT (PARENTS) 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.
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