A mixed-methods study of childbirth-related intrusive memories and their relationship with posttraumatic stress symptoms

Background About 12% of mothers experience childbirth-related posttraumatic stress symptoms (CB-PTSS), which include childbirth-related intrusive memories (CB-IM). These memories involve the involuntary re-experiencing of distressing moments of the birth. Although CB-IM are the hallmark of a traumatic childbirth, there is limited knowledge about their content and other characteristics. This study aims to rigorously investigate the characteristics of CB-IM (count, content, and associated nowness, distress, and sensory modalities) and their relationships with CB-PTSS, which may ultimately inform the development of clinical interventions.Methods Forty-four participants reported the characteristics of the 299 CB-IM they experienced in a 14-day long diary and their CB-PTSS in a questionnaire. A qualitative content analysis was performed on CB-IM content. Linear regressions and Poisson-like regression models tested the associations between different CB-IM characteristics and then with CB-PTSS.Results Six CB-IM content categories were identified: Physiological process of birth (11.78% of CB-IM qualitative content), Perceptions of complications (16.67%), Experiences of medical procedures (21.72%), Interpersonal stressors (17.68%), Negative emotions (18.01%), and Physical environment (14.14%). Re-experiencing Negative emotions (IRR = 1.05; p = .028) and Physical environment (IRR = 1.08; p = .010) was associated with more CB-PTSS.Conclusion To our knowledge, this is the first study to investigate the contents of CB-IM, and the associations of CB-IM characteristics with CB-PTSS, which is valuable knowledge for supporting individually tailored treatments.