Birth expectations, birth experiences and childbirth‐related post‐traumatic stress symptoms in mothers and birth companions: Dyadic investigation using response surface analysis

Abstract

Objectives: During the perinatal period, women and their birth companions form expectations about childbirth. We aimed to examine whether a mismatch between birth expectations and experiences predict childbirth‐related post‐traumatic stress symptoms (CB‐PTSS) for mothers and birth companions. We also explored the influence of the mismatch between mothers' and birth companions' expectations/experiences on CB‐PTSS. Design: Dyadic longitudinal data from the Self‐Hypnosis IntraPartum Trial. Methods: Participants (n = 469 mothers; n = 358 birth companions) completed questionnaires at 27 and 36 weeks of gestation and 2 and 6 weeks post‐partum. We used the measures of birth expectations (36 weeks gestation), birth experiences (2 weeks post‐partum) and CB‐PTSS (6 weeks post‐partum). Results: Correlations revealed that birth expectations were associated with experiences for both mothers and birth companions but were not consistently associated with CB‐PTSS. Birth experiences related to CB‐PTSS for both mothers and birth companions. The response surface analysis results showed no support for the effect of a mismatch between expectations and experiences on CB‐PTSS in mothers or birth companions. Similarly, a mismatch between mothers' and birth companions' expectations or experiences was unrelated to CB‐PTSS. Conclusions: Following previous literature, birth expectations were associated with experiences, and experiences were associated with CB‐PTSS. By testing the effect of the match between birth experiences and expectations using an advanced statistical method, we found that experiences play a more substantial role than the match between experiences and expectations in CB‐PTSS. The impact of birth experiences on CB‐PTSS highlights the importance of respectful and supportive maternity care.