Peripartum dissociation, sense of control, postpartum posttraumatic stress disorder and emotional adjustment to motherhood in adult survivors of childhood maltreatment

Inbal Brenner*, Karni Ginzburg, Ayelet Golan, May Shir Igawa, Ido Lurie, Yael Reicher, Anat Talmon, Roni Tomashev, Anna Padoa

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Survivors of childhood maltreatment (CM) may experience difficulties in the peripartum period and in adjustment to motherhood. In this study we examined a model wherein CM is associated with maternal self-efficacy and maternal bonding three months postpartum, through mediation of peripartum dissociation and reduced sense of control during childbirth and postpartum-posttraumatic-stress disorder (P-PTSD). Women were recruited in a maternity ward within 48 h of childbirth (T1, N = 440), and contacted three-months postpartum (T2, N = 295). Participants completed self-report questionnaires: peripartum dissociation, sense of control (T1), and CM, P-PTSD, postpartum-depression, maternal self-efficacy and bonding (T2). Obstetrical data were collected from medical files. Structural equation modeling was conducted to test the hypothesized model, controlling for mode of delivery and postpartum-depression. Reported CM included child emotional neglect (CEN; 23.5%), child emotional abuse (CEA; 16.3%), child sexual abuse (CSA; 12.9%) and child physical abuse (CPA; 7.1%). CM was positively associated with peripartum dissociation and P-PTSD (p <.001). Peripartum dissociation was positively associated with P-PTSD (p <.001). P-PTSD was negatively associated with maternal self-efficacy (p <.001) and maternal bonding (p <.001). Association between CM and maternal self-efficacy and bonding was serially mediated by peripartum dissociation and P-PTSD, but not by sense of control. Findings remained significant after controlling for mode of delivery and postpartum-depression. CM is a risk factor for adjustment to motherhood, owing to its effects on peripartum dissociation and P-PTSD. Implementation of a trauma-informed approach in obstetric care and recognition of peripartum dissociative reactions are warranted.

Original languageAmerican English
Pages (from-to)127-136
Number of pages10
JournalArchives of Women's Mental Health
Volume27
Issue number1
DOIs
StatePublished - Feb 2024

Bibliographical note

Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.

Keywords

  • Adjustment to Motherhood
  • Adverse childhood experiences
  • Dissociation
  • Peritraumatic reactions
  • Postpartum PTSD

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