SOCIAL REACTIONS TO DISCLOSURE OF TRAUMATIC CHILDBIRTH EXPERIENCES: ASSOCIATIONS WITH COPING, POSTTRAUMATIC COGNITIONS, AND TRAUMATIC STRESS AND DEPRESSIVE SYMPTOMOLOGY

Abstract

Traumatic childbirth experiences can contribute to symptoms of postpartum depression and posttraumatic stress disorder (PTSD). Negative or unsupportive responses from social partners to disclosure (i.e., communication of personally relevant information, thoughts and feelings) of a traumatic event may maintain symptoms of psychological distress after the stressor has passed. Negative or unsupportive responses to disclosure may influence distress through increased use of maladaptive coping strategies and posttraumatic cognitions. The present study was a mixed methodological investigation into disclosure of traumatic childbirth experiences, social responses to that disclosure, and their relationship with postpartum psychological distress (i.e., depressive and PTSD symptoms) in a sample of women in the first year postpartum following a traumatic childbirth experience (N = 129). Mediation analyses assessed maladaptive coping and posttraumatic cognitions as mediators of the relationship between unsupportive responses to disclosure and postpartum depressive and PTSD symptoms in separate, simple mediation models. In qualitative analyses, the majority of women identified medical characteristics (>80%) as a contributor to traumatic childbirth appraisal. Increased perception of risk was the next most commonly reported theme (>25%). Over three-in-four women reported that they disclosed their traumatic childbirth to at least one person (78%). The most common disclosure methods were in person (90%) and online (65%), and women most often reported disclosing to individuals with whom they likely had close, personal relationships (87% partner, 82% family, 81% friend). Participants reported that they most often disclosed as a means of coping (90%), and anticipated negative reactions from social partners was the most reported reasons for not disclosing (38%). There was no difference in severity of postpartum depression or PTSD symptoms between women who did disclose and those who did not. In women who did disclose, degree of unsupportive social responses to disclosure was significantly positively associated with maladaptive coping, posttraumatic cognitions, depressive symptoms, and PTSD symptoms. Maladaptive coping and posttraumatic cognitions were also significantly positively related to depressive and PTSD symptoms in separate analyses. As hypothesized, maladaptive coping and posttraumatic cognitions mediated the relationship between unsupportive social responses to disclosure and depressive and PTSD symptoms in simple mediation analysis. These results are the first to identify the proportion of women who disclosed a traumatic childbirth experience and explore unsupportive responses from social partners to that disclosure. This is also the first analysis of relationship between unsupportive social interactions, maladaptive coping, posttraumatic cognitions, and psychological distress in a postpartum sample. Results highlight the need for improved postpartum emotional support.