Preventing Risk for Posttraumatic Stress Following Childbirth: Visual Biofeedback During Childbirth Increases Maternal Connectedness to Her Newborn Thereby Preventing Risk for Posttraumatic Stress Following Childbirth

Objective: Mounting evidence indicates the detrimental impact of posttraumatic stress following childbirth (PTS-FC). Nevertheless, research on preventive strategies is scarce. We recently reported that ultrasound visual biofeedback during second stage of labor was associated with immediate beneficial medical outcomes (increased pushing efficacy, decreased perineal tearing), as well as greater feelings of maternal connectedness toward her newborn immediately postlabor. The current study assessed the potential longer-term psychological benefits of these outcomes in buffering risk for PTS-FC. The study follows up the previously reported sample to examine the longitudinal clinical effect of the visual biofeedback intervention on symptoms of acute stress at 2 days postpartum and subsequent symptoms of PTS-FC at 1 month postpartum. Method: A sample of 26 nulliparous women received visual biofeedback and was compared to a group of women receiving standard obstetrical coaching. Maternal feelings of connectedness and acute stress symptoms were assessed 2 days postpartum and PTS-FC was assessed 1 month postpartum. Results: Double-mediation analyses revealed a significant indirect relation between visual biofeedback and decreased PTS-FC symptoms 1 month postpartum. The relation was significantly mediated by increased feelings of maternal connectedness immediately postpartum, which in turn was associated with decreased symptoms of acute stress 2 days postpartum. Conclusions: These results suggest that the visual biofeedback intervention during childbirth may decrease risk for PTS-FC. Importantly, findings suggest the preventive potential of fostering feelings of maternal connectedness toward her newborn to reduce symptoms of PTS-FC. Clinical Impact Statement This is the first study to demonstrate the preventive long-term potential of visual biofeedback administered during childbirth for improving maternal psychological outcomes; that is, reducing acute stress 2 days postpartum, as well as subsequent symptoms of Post-Traumatic Stress Following Childbirth (PTS-FC) at 1 month postpartum. Furthermore, this is first study to highlight the role of maternal feelings of connectedness toward her newborn in mediating biofeedback-related reduction of stress symptoms. Although further research is necessary, these initial results point toward maternal feelings of connectedness as a preventive mechanism, thus underscoring the importance of fostering such feelings during the childbirth event.