The impact of perinatal healthcare changes on birth trauma during COVID-19

Women Birth. 2022 Sep;35(5):503-510. doi: 10.1016/j.wombi.2021.12.003. Epub 2021 Dec 11.


Background: Since the onset of COVID-19, giving birth has involved navigating unprecedented healthcare changes that could significantly impact the psychological birth experience.

Aim: Research has demonstrated increasing rates of birth trauma and birth plan alterations during the COVID-19 pandemic. This study specifically examined these intersecting experiences to understand how COVID-related healthcare changes have impacted birth trauma during the pandemic.

Methods: 269 people who gave birth in the U.S. during COVID-19 completed an online survey between November, 2020-May, 2021 which included questions about COVID-related perinatal healthcare changes and birth-related posttraumatic stress disorder (PTSD; The City Birth Trauma Scale). T-tests were run on birth demographics to assess for significant indicators of PTSD; variables having significant effects were used to build a hierarchical regression model to predict PTSD symptoms.

Findings: 5.9% of the sample met criteria for PTSD and 72.3% met partial criteria. The overall regression model predicted approximately 19% of variance in total PTSD symptoms. Labor and birth demographics were entered in Step 1 and predicted approximately 11% of variance: limited length of stay for support person, being allowed 1 support person who had to be the same, and mask requirements were significant predictors of PTSD. Variables related to birth plan changes were entered in Step 2 and predicted approximately 8% of variance: changes to support person(s) for labor and birth, breastfeeding plans, and birth location were significant predictors of PTSD.

Conclusion: The present study demonstrates the importance of COVID-related perinatal healthcare changes to the development of trauma symptoms following childbirth.

Keywords: Birth; Birth trauma; COVID-19; Mental health; Postpartum; Posttraumatic stress disorder (PTSD).

MeSH terms

  • COVID-19* / epidemiology
  • Delivery of Health Care
  • Female
  • Humans
  • Pandemics
  • Parturition / psychology
  • Pregnancy
  • Stress Disorders, Post-Traumatic* / diagnosis
  • Stress Disorders, Post-Traumatic* / epidemiology
  • Stress Disorders, Post-Traumatic* / etiology