Abstract
INTRODUCTION: Childbirth, traditionally viewed as a natural and positive process, can become a traumatic experience when obstetric violence or disrespectful treatment occurs. This type of experience can cause symptoms consistent with Post-Traumatic Stress Disorder negatively affecting maternal mental health, bonding with the newborn, and the development of the newborn. OBJECTIVES: To analyze the relationship between perceptions of inadequate treatment during childbirth and the risk of postpartum Post-Traumatic Stress Disorder at 6 months in a sample of women assessed 3 months after birth. METHODS: An observational study with six-month follow-up was conducted in 341 women in Spain, initially recruited 3 months postpartum. Validated questionnaires were used: Childbirth Abuse and Respect Evaluation-Maternal Questionnaire (perceived abuse or disrespect), Perinatal Post Traumatic Stress Disorder, Family Apgar, and MOS social support survey Bivariate and multivariate analyses were performed using logistic regression. RESULTS: Three hundred forty-one women participated, with a mean age of 33.38 years (SD = 4.23). 10.9% of the participants were at risk of Post-Traumatic Stress Disorder. Childbirth Abuse and Respect Evaluation-Maternal Questionnaire dimensions correlated positively with the Perinatal Post Traumatic Stress Disorder, with "inappropriate treatment by professionals" being the most significant (r = 0.60; 95% CI: 0.53-0.67). A greater perception of obstetric violence (Abuse and Respect Evaluation-Maternal Questionnaire ≥ P95) significantly increased the likelihood of developing Perinatal Post Traumatic Stress Disorder (aOR: 48.38; 95%CI: 10.07-232.44). Associations with risk of developing Post-Traumatic Stress Disorder were also observed for instrumental birth (aOR: 5.29; 95% CI: 1.53-18.28) and previous cesarean section (aOR: 7.54; 95% CI: 1.10-51.79). More social support was associated with a lower risk of Post-Traumatic Stress Disorder (aOR: 0.96; 95%CI: 0.94-0.99). DISCUSSION AND CONCLUSION: A higher perception of obstetric violence is associated with an increased risk of developing postpartum Post-Traumatic Stress Disorder. Furthermore, invasive interventions such as instrumental births or previous cesarean sections increase psychological vulnerability. In contrast, social support acts as a protective factor. It is recommended to implement screening tools such as Abuse and Respect Evaluation-Maternal Questionnaire, reinforce training in respectful treatment, and promote humane care models to ensure the physical and emotional safety of women.