Journal of Public Health

, Volume 25, Issue 3, pp 275–280 | Cite as

Prevalence and risk factors for developing traumatic childbirth in Iran

  • Sedigheh Abdollahpour
  • Seyed Abbas Mousavi
  • Zahra Motaghi
  • Afsaneh Keramat
  • Ahmad KhosraviEmail author
Original Article



Traumatic childbirth is among the important factors that make childbirth an unpleasant experience and has psychological negative effects on women. This study aimed to determine the prevalence and risk factors associated with traumatic childbirth.

Subject and methods

In this cross-sectional study, 400 women were interviewed in the first 48 h after childbirth in Torbate-heydariyeh (eastern Iran) in 2015. Traumatic childbirth was determined based on DSM-V-A criteria. Statistical analysis of the data was done through chi-square and logistic regression.


The prevalence of traumatic childbirth was 48.3% (N = 193). Logistic regression showed variables such as place of residence, type of delivery, pregnancy complications, bleeding during pregnancy, rupture of grade 3 or 4 during delivery, and emergency cesarean section were significantly correlated with traumatic childbirth (p <0.001).


Considering the high prevalence of traumatic childbirth, it is recommended that its associated risk factors be identified so that negative psychological consequences for the mother can be prevented.


Traumatic childbirth Childbirth Post-traumatic stress disorder 



This article is a portion of a master’s thesis in obstetrics which was conducted and sponsored by the Shahroud University of Medical Sciences. The researchers express their thanks to the Deputy of Research in Shahroud University of Medical Sciences and to the staff of the Postpartum Ward of Nohom Dey Hospital in Torbat Heydarieh. Special thank also goes to and all the mothers who participated in this project.

Compliance with ethical standards


The current study has been funded by Shahroud University of Medical Sciences, approved and registered in the Research Ethics Committee at Shahroud University of Medical Sciences (with the registration number IR-SHMU.REC.1394.42).

Conflict of interest

Standards Authors Sedigheh Abdollahpour, Seyed Abbas Mousavi, Zahra Motaghi, Afsaneh Keramat, Ahmad Khosravi declare that they have no conflicts of interests to disclose.

Ethical approval

The authors have adhered to the appropriate ethical standards, all procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Ethical Committee of the Shahroud University of Medical Sciences (IR-SHMU.REC.1394.42).

Informed consent

A written Informed consent was obtained from all individual participants included in the study.


  1. APA (2013) Diagnostic and statistical manual of mental disorders: DSM-5, 5th edn. American Psychiatric Association, Arlington, VAGoogle Scholar
  2. Adewuya AO, Ologun YA, Ibigbami OS (2006) Post-traumatic stress disorder after childbirth in Nigerian women: prevalence and risk factors. BJOG 113(3):284–288. doi: 10.1111/j.1471-0528.2006.00861.x CrossRefPubMedGoogle Scholar
  3. Alcorn KL, O’Donovan A, Patrick JC, Creedy D, Devilly GJ (2010) A prospective longitudinal study of the prevalence of post-traumatic stress disorder resulting from childbirth events. Psychol Med 40(11):1849–1859. doi: 10.1017/s0033291709992224 CrossRefPubMedGoogle Scholar
  4. Andersen LB, Melvaer LB, Videbech P, Lamont RF, Joergensen JS (2012) Risk factors for developing post-traumatic stress disorder following childbirth: a systematic review. Acta Obstet Gynecol Scand 91(11):1261–1272. doi: 10.1111/j.1600-0412.2012.01476.x CrossRefPubMedGoogle Scholar
  5. Ayers S, Pickering AD (2001) Do women get posttraumatic stress disorder as a result of childbirth? A prospective study of incidence. Birth 28(2):111–118CrossRefPubMedGoogle Scholar
  6. Ayers S, McKenzie-McHarg K, Eagle A (2007) Cognitive behaviour therapy for postnatal post-traumatic stress disorder: case studies. J Psychosom Obstet Gynecol 28(3):177–184CrossRefGoogle Scholar
  7. Azizi M, Lamyian M, Faghihzade S, Nematollahzade M (2010) The effect of counseling on anxiety after traumatic childbirth in nulliparous women; a single blind randomized clinical trial. J Kermanshah Univ Med Sci 14(3)Google Scholar
  8. Beck CT (2015) Middle range theory of traumatic childbirth the ever-widening ripple effect. Glob Qual Nursing Res 2:1–13Google Scholar
  9. Beck CT, Dnsc C, Driscoll JW, Watson S (2013) Traumatic childbirth. Routledge, Abingdon, UKGoogle Scholar
  10. Cantwell R, Clutton-Brock T, Cooper G, Dawson A, Drife J, Garrod D, Springett A (2011) Saving mothers’ lives: reviewing maternal deaths to make motherhood safer: 2006–2008. The Eighth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. BJOG 118(Suppl 1):1–203. doi: 10.1111/j.1471-0528.2010.02847.x PubMedGoogle Scholar
  11. Creedy DK, Shochet IM, Horsfall J (2000) Childbirth and the development of acute trauma symptoms: incidence and contributing factors. Birth 27(2):104–111CrossRefPubMedGoogle Scholar
  12. Czarnocka J, Slade P (2000) Prevalence and predictors of post-traumatic stress symptoms following childbirth. Br J Clin Psychol 39(Pt 1):35–51CrossRefPubMedGoogle Scholar
  13. Engelhard IM, van den Hout MA, Arntz A (2001) Posttraumatic stress disorder after pregnancy loss. Gen Hosp Psychiatry 23(2):62–66CrossRefPubMedGoogle Scholar
  14. Engelhard IM, van Rij M, Boullart I, Ekhart TH, Spaanderman ME, van den Hout MA, Peeters LL (2002) Posttraumatic stress disorder after pre-eclampsia: an exploratory study. Gen Hosp Psychiatry 24(4):260–264CrossRefPubMedGoogle Scholar
  15. Furuta M, Sandall J, Bick D (2012) A systematic review of the relationship between severe maternal morbidity and post-traumatic stress disorder. BMC Pregnancy Childbirth 12:125. doi: 10.1186/1471-2393-12-125 CrossRefPubMedPubMedCentralGoogle Scholar
  16. Gamble J, Creedy D, Moyle W, Webster J, McAllister M, Dickson P (2005) Effectiveness of a counseling intervention after a traumatic childbirth: a randomized controlled trial. Birth 32(1):11–19. doi: 10.1111/j.0730-7659.2005.00340.x CrossRefPubMedGoogle Scholar
  17. Modarres M, Afrasiabi S, Rahnama P, Montazeri A (2012) Prevalence and risk factors of childbirth-related post-traumatic stress symptoms. BMC Pregnancy Childbirth 12:88. doi: 10.1186/1471-2393-12-88 CrossRefPubMedPubMedCentralGoogle Scholar
  18. Moghadam MF, Shamsi A, Moro FH (2015) The prevalence of post-traumatic stress disorder among women with normal vaginal delivery in Zahedan city. Arch Psychiatry Psychother 1:15–19CrossRefGoogle Scholar
  19. O’Donovan A, Alcorn KL, Patrick JC, Creedy DK, Dawe S, Devilly GJ (2014) Predicting posttraumatic stress disorder after childbirth. Midwifery 30(8):935–941. doi: 10.1016/j.midw.2014.03.011 CrossRefPubMedGoogle Scholar
  20. Peeler S, Chung MC, Stedmon J, Skirton H (2013) A review assessing the current treatment strategies for postnatal psychological morbidity with a focus on post-traumatic stress disorder. Midwifery 29(4):377–388. doi: 10.1016/j.midw.2012.03.004 CrossRefPubMedGoogle Scholar
  21. Ryding EL, Wijma B, Wijma K (1997) Posttraumatic stress reactions after emergency cesarean section. Acta Obstet Gynecol Scand 76(9):856–861CrossRefPubMedGoogle Scholar
  22. Soderquist J, Wijma K, Wijma B (2002) Traumatic stress after childbirth: the role of obstetric variables. J Psychosom Obstet Gynaecol 23(1):31–39CrossRefPubMedGoogle Scholar
  23. Soderquist J, Wijma B, Wijma K (2006) The longitudinal course of post-traumatic stress after childbirth. J Psychosom Obstet Gynaecol 27(2):113–119CrossRefPubMedGoogle Scholar
  24. Soderquist J, Wijma B, Thorbert G, Wijma K (2009) Risk factors in pregnancy for post-traumatic stress and depression after childbirth. BJOG 116(5):672–680. doi: 10.1111/j.1471-0528.2008.02083.x CrossRefPubMedGoogle Scholar
  25. Soet JE, Brack GA, DiIorio C (2003) Prevalence and predictors of women’s experience of psychological trauma during childbirth. Birth 30(1):36–46CrossRefPubMedGoogle Scholar
  26. Taghizadeh Z, Jafarbegloo M, Arbabi M, Faghihzadeh S (2007) The effect of counseling on post traumatic stress disorder after a traumatic childbirth. Hayat 13(4):23–31Google Scholar
  27. Vizeh M, Kazemnejaz A, Afrasiabi S, Rouyhi M, Hassan M, Habibzadeh S (2012) Prevalance of post traumatic stress disorder after childbirth and its precipitating factors. Bimonthly J Hormozgan Univ Med Sci 16(4):309–316Google Scholar
  28. Wen SW, Huang L, Liston R, Heaman M, Baskett T, Rusen ID, Joseph KS, Kramer MS, Maternal Health Study Group, Canadian Perinatal Surveillance System (2005) Severe maternal morbidity in Canada, 1991–2001. CMAJ 173(7):759–764. doi: 10.1503/cmaj.045156 CrossRefPubMedPubMedCentralGoogle Scholar
  29. Wijma K, Soderquist J, Wijma B (1997) Posttraumatic stress disorder after childbirth: a cross sectional study. J Anxiety Disord 11(6):587–597CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Sedigheh Abdollahpour
    • 1
  • Seyed Abbas Mousavi
    • 2
  • Zahra Motaghi
    • 3
  • Afsaneh Keramat
    • 4
  • Ahmad Khosravi
    • 4
    Email author
  1. 1.Student Research Committee, School of Nursing and MidwiferyShahroud University of Medical SciencesShahroudIran
  2. 2.Research Center of PsychiatryGolestan University of Medical SciencesGorganIran
  3. 3.Department of Midwifery, School of Nursing and MidwiferyShahroud University of Medical SciencesShahroudIran
  4. 4.Center for Health Related Social and Behavioral Sciences ResearchShahroud University of Medical SciencesShahroudIran

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