Childbirth-related posttraumatic stress symptoms: exploring the predictive potential of intrapartum hotspots

Childbirth can be a highly stressful event, in some cases leading to posttraumatic stress symptoms. While the subjective experience of childbirth (SBE) is a key predictor of childbirth-related posttraumatic stress symptoms (CB-PTSS), the specific defining characteristics of stressful birth experiences remain poorly understood. This study aims to shed light on a specific aspect of SBEs by exploring intrapartum hotspots (i.e., moments of extreme distress during childbirth) and their association with CB-PTSS. In a cross-sectional online study of N = 1,140 individuals who had given birth eight-ten weeks before, we examined the following: 1) the types of hotspots experienced, 2) differences in hotspot-related distress, interpersonal difficulties during the hotspot, and CB-PTSS between the various types of hotspots, and 3) whether hotspot-related distress and interpersonal difficulties during the hotspot independently predicted CB-PTSS. Participants completed the newly developed Hotspot Scale. Based on previous qualitative research, the scale evaluates various types of hotspots, hotspot-related distress, and interpersonal difficulties during intrapartum hotspots. Additionally, participants completed the City Birth Trauma Scale to measure CB-PTSS, alongside relevant pregnancy- and birth-related questions. Findings revealed that medical interventions were the most frequently experienced hotspot. Participants who reported separation from the child experienced the highest levels of hotspot-related distress, interpersonal difficulties, and CB-PTSS. Hotspot-related distress and interpersonal difficulties independently predicted CB-PTSS while accounting for known risk factors. Screening individuals after giving birth for the type of hotspot they experienced and assessing distress and interpersonal difficulties during the hotspot could be a promising approach to identify individuals at risk for CB-PTSS.