Top Takeaways
Women who experienced more severe sexual maltreatment in childhood tended to have more distressing birth experiences. For example, they were more likely to feel a loss of control, a lack of support, or fear for their baby's health during delivery.
Trauma symptoms late in pregnancy, not fear of giving birth, helped explain this link. Symptoms like flashbacks, feeling on edge, or feeling emotionally numb in the third trimester partly accounted for why women with childhood sexual maltreatment histories had harder births. General worry about labor did not. This suggests that treating trauma symptoms before delivery could help improve birth experiences.
This pattern appeared most clearly among women of color, though more research is needed. The link through trauma symptoms was statistically meaningful only for women of color. However, the difference between women of color and white women wasn't large enough to conclude that the process truly works differently across groups. Larger studies are needed.
Abstract
Purpose
Childhood sexual maltreatment is a well-documented risk factor for adverse perinatal physical and mental health outcomes, which are worse in women of color compared to white women. Yet, the pathways through which early sexual trauma influences childbirth experiences and the role of ethnicity/race in these associations are insufficiently understood. This study examined the relationship between childhood sexual maltreatment and negative childbirth experiences, with a focus on the potential mediating roles of late-pregnancy posttraumatic stress symptoms (PTSS) and fear of childbirth. Ethnic/racial group differences were also evaluated.
Methods
Women (N = 433) were drawn from the Michigan Prenatal Stress Study, a large longitudinal, prospective study of the influence of prenatal stressors on mother and infant outcomes. Participants reported on childhood sexual maltreatment, PTSS, fear of giving birth (third trimester), negative childbirth experiences, and ethnic/racial identity.
Results
Childhood sexual maltreatment was significantly associated with more negative childbirth experiences, and late-pregnancy PTSS mediated this association. Although this PTSS-mediated pathway did not significantly differ by ethnic/racial groups, it was only significant among women of color.
Conclusions
Findings highlight the importance of addressing trauma-related stress during pregnancy to improve perinatal outcomes for all women with a history of childhood sexual maltreatment. Targeted interventions aimed at reducing PTSS in pregnancy may mitigate the impact of childhood sexual trauma on childbirth experiences and promote maternal and infant well-being.