Investigation of the Relationship Between the Perception of Trauma Related to Childbirth and the Level of Maternal Attachment of Mothers Who Vaginal Gave Birth: A Cross Sectional Study

Yıl 2022, Cilt: 11 Sayı: 1, 158 - 169, 19.03.2022

Ruveyde AYDIN Songül AKTAŞ Dilek KALOĞLU BİNİCİ

https://doi.org/10.37989/gumussagbil.1051454

Öz

The aim of the study is to examine the relationship between the perception of childbirth trauma and the maternal attachment level of mothers who gave birth vaginally. The sample of the cross-sectional study consists of 165 mothers who gave birth vaginally and were between 1 and 6 months after birth. Data was collected between May and October 2021 with “Mother Descriptive Information Form”, “Birth Trauma Perception” and “Maternal Attachment Scale Form”. Descriptive statistics and multiple linear regression analysis were used in the analysis of the data. The mean age of the mothers was 29.00±5.169, the mean time after birth was 4.69±3.64 months, and 58% of them were primiparous. 54%of the mothers gave birth only with the help of a midwife, 40% both a midwife and a obstetrician and 6% of them with the help of a physician. It was found that the "Birth Trauma Perception of the mothers was higher than the average (113.35±13.84), "Maternal Attachment" was high level (99.75±5.20). It was determined that the increase in the traumatic birth perception score of the mothers had a decreasing effect on the level of maternal attachment (β=-0.08 p=0.025). It was determined that there is a negative relationship between the perception of traumatic birth and maternal attachment, and that some socio-demographic and obstetric factors of mothers have an effect on birth trauma and maternal attachment. Midwives and nurses responsible for perinatal care have important responsibility in providing positive birth experience to mothers, reducing traumatic births, and strengthening mother attachment.

Anahtar Kelimeler

vaginal birth, mother, traumatic birth, maternal attachment, perception of birth, midwife, nurse

Vajinal Doğum Yapan Annelerin Doğuma İlişkin Travma Algısı İle Maternal Bağlanma Düzeyi Arasındaki İlişkinin İncelenmesi: Bir Kesitsel Çalışma

Öz

Çalışmada amaç; vajinal doğum yapan annelerin doğuma ilişkin travma algısı ile maternal bağlanma düzeyi arasındaki ilişkiyi incelemektir. Kesitsel tipte olan araştırmanın örneklemini vajinal doğum yapan ve doğum sonrası 1 ile 6 ay arası olan 165 anne oluşturmaktadır. Çalışmanın verileri; Mayıs-Ekim 2021 tarihleri arasında “Anne Tanıtıcı Bilgi Formu”, “Doğuma İlişkin Travma Algısı Ölçeği ” ve “Maternal Bağlanma Ölçeği” kullanılarak online toplanmıştır. Verilerin analizinde; tanımlayıcı istatistikler ile çoklu doğrusal regresyon analizi kullanılmıştır. Annelerin yaş ortalaması 29,00±5,169, doğumundan sonra geçen ortalama süre 4,69±3,64 ay ve %58’i primipardır. Doğumunu annelerin %54’ü yanlızca ebe, %40’ı hem ebe hem hekim, %6’sı hekim yardımıyla gerçekleştirmiştir. Annelerin “Doğuma İlişkin Travma Algısı (113,35±13,84)” düzeyi ortalamanın üzerinde, “Maternal Bağlanması (99,75±5,20)” yüksek düzeyde saptanmıştır. Çalışmada annelerin travmatik doğum algısı düzeyinin artmasının, maternal bağlanma düzeyi üzerine azaltıcı etkisinin olduğu saptanmıştır (β=-0,08 p=0,025). Sonuç olarak travmatik doğum algısı ile maternal bağlanma arasında negatif ilişkinin olduğu, annelerin bazı sosyo-demografik ve obstetrik faktörlerinin (doğum memnuniyeti vb.), doğum travması ve maternal bağlanma üzerine etkisinin olduğu saptanmıştır. Ebe ve hemşirelere; annelere pozitif doğum deneyimi sağlama, travmatik doğumlarını azaltma, anne-bebek bağlanmasını güçlendirmede önemli görevler düşmektedir.

Anahtar Kelimeler

vajinal doğum, Anne, Travmatik doğum, Maternal bağlanma, Doğum algısı, Ebe

Kaynakça

• 1. Aktaş, S. and Aydın, R. (2019). “The analysis of Negative Birth Experiences of Mothers: A Qualitative Study”. Journal of Reproductive Infant Psychology, 37 (2), 176-192. https:// doi: 10.1080/02646838.2018.1540863
• 2. McKelvin, G, Thomson, G. and Downe, S. (2021). “The Childbirth Experience: A Systematic Review of Predictors and Outcomes”. Women Birth, 34 (5), 407-416. https://doı:10.1016/j.wombi.2020.09.021
• 3. Ponti, L, Smorti, M, Ghinassi, S, Mannella, P. and Simoncini, T. (2020). “Can a Traumatic Childbirth Experience Affect Maternal Psychopathology and Postnatal Attachment Bond?”. Current Psychology, 1-6. https://doi.org/10.1007/s12144-020-00650-2
• 4. Delicate, A, Ayers, S. and McMullen, S. (2022). “Health-Care Practitioners’ Assessment and Observations of Birth Trauma in Mothers and Partners”. Journal of Reproductive and Infant Psychology, 40 (1), 34-46. https://doi.org/10.1080/02646838.2020.1788210
• 5. Ayers, S, Bond, R, Bertullies, S. and Wijma, K. (2016). “The Aetiology of Post-Traumatic Stress Following Childbirth: A Meta-Analysis and Theoretical Framework”. Psychological Medicine, 46 (6), 1121-1134. https://doi: 10.1017/S0033291715002706
• 6. Dekel, S, Stuebe C. and Dishy, G. (2017). “Childbirth Induced Posttraumatic Stress Syndrome: A Systematic Review of Prevalence and Risk Factors”. Frontiers in Psychology, 8, 560. doi: 10.3389/fpsyg.2017.00560
• 7. Dikmen Yildiz, P, Ayers, S. and Phillips, L. (2017). “Depression, Anxiety, PTSD and Comorbidity in Perinatal Women in Turkey: A Longitudinal Population-Based Study”. Midwifery, 55, 29-37. https://doi: 10.1016/j.midw.2017.09.001
• 8. Ghanbari Homayi, S, Fardiazar, Z, Meedya, S, Mohammad Alizadeh Charandabi, S, Asghari Jafarabadi, M, Mohammadi, E. and Mirghafourvand, M. (2019). “Predictors of Traumatic Birth Experience Among a Group of Iranian Primipara Women: A Cross Sectional Study”. BMC Pregnancy Childbirth, 19 (1), 1-9. https://doi: 10.1186/s12884-019-2333-4
• 9. Grekin, R. and O'Hara, M.W. (2014). “Prevalence and Risk Factors of Postpartum Posttraumatic Stress Disorder: A Meta-Analysis”. Clinical Psychology Review, 34 (5), 389-401. https://doi: 10.1016/j.cpr.2014.05.003
• 10. Kjerulff, K.H, Attanasio, L.B, Sznajder, K.K, and Brubaker, L.H. (2021). “A Prospective Cohort Study of Post-Traumatic Stress Disorder and Maternal-Infant Bonding After First Childbirth”. Journal of Psychosomatic Research, 144, 110424. https://doi: 10.1016/j.jpsychores.2021.110424
• 11. Mayopoulos, G.A, Ein Dor, T, Dishy, G.A, Nandru, R, Chan, S.J, Hanley, L.E, Kaimal, A.J. and Dekel, S. (2021). “COVID-19 is Associated with Traumatic Childbirth and Subsequent Mother-Infant Bonding Problems”. Journal of Affective Disorders, 282, 122-125. https://doi: 10.1016/j.jad.2020.12.101
• 12. Lang, C. (2017). “Fizyolojik Bağlanma”. In: N. ÜZEL, S. ÖZBALCI (Eds). Bağlanma Doğum Öncesi ve Sonrası Dönemde Bağlanmanın Güçlendirilmesi. (29-42). Ankara: Modern Tıp Kitabevi.
• 13. Davies, J, Slade, P, Wright, I. and Stewart, P. (2008). “Posttraumatic Stress Symptoms Following Childbirth and Mothers' Perceptions of Their Infants”. Infant Mental Health Journal, 29 (6), 537-554. https://doi: 10.1002/imhj.20197
• 14. Dekel, S, Thiel, F, Dishy, G. and Ashenfarb, A.L. (2019). “Is Childbirth-Induced PTSD Associated with Low Maternal Attachment?” Archives of Women's Mental Health, 22 (1), 119-122. https://doi: 10.1007/s00737-018-0853-y
• 15. Baştürk, S. ve Taştepe, M. (2013). “Evren ve Örneklem. Bilimsel Araştırma Yöntemleri”. Ankara: Vize Yayıncılık.
• 16. Çankaya, S, Dereli Yılmaz, S, Can, R. ve Değerli Kodaz, N. (2017). “Postpartum Depresyonun Maternal Bağlanma Üzerine Etkisi”. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, (4), 232-240.
• 17. Handelzalts, J.E, Levy, S, Molmen Lichter, M, Ayers, S, Krissi, H, Wiznitzer, A, and Peled, Y. (2021). “The Association of Attachment Style, Postpartum PTSD and Depression with Bonding-A Longitudinal Path Analysis Model, from Childbirth to Six Months”. Journal of Affective Disorders, 280, 17-25. https://doi: 10.1016/j.jad.2020. 10.068
• 18. Smorti, M, Ponti, L, Ghinassi, S. and Rapisardi, G. (2020). “The Mother-Child Attachment Bond Before and After Birth: The Role of Maternal Perception of Traumatic Childbirth”. Early Human Development, 142, 104956. https://doi: 10.1016/j.earlhumdev.2020.104956
• 19. Mucuk, Ö. (2020). Developing the Trauma Perception Scale for Regarding Delivery. Doktora Tezi. Atatürk University Institute of Health Sciences, Department of Midwifery, Erzurum.
• 20. Bay, F. and Sayiner, F.D. (2021). “Perception of Traumatic Childbirth of Women and Its Relationship with Postpartum Depression”. Women & Health, 1-11. https://doi: 10.1080/03630242.2021.1927287
• 21. Türkmen, H, Yalnız Dilcen, H. and Aslantekin Özçoban, F. (2021) “Traumatic Childbirth Perception During Pregnancy and The Postpartum Period and Its Postnatal Mental Health Outcomes: A Prospective Longitudinal Study”. Journal of Reproductive Infant Psychology, 39 (4), 422-434. https://doı: 10.1080/02646838.2020.1792429
• 22. Aydın, R. and Aktaş, S. (2021). “An investigation of Women’s Pregnancy Experiences During The Covid‐19 Pandemic: A Qualitative Study”. International Journal of Clinical Practice, e14418. https:// doi: 10.1111/ijcp.14418
• 23. Yazıcı Topçu, T. and Aktaş, S. (2021). “An Investigation of the Relationship between Health Literacy Levels of Pregnant Women and Their Perceptions of Traumatic Childbirth”. Social Work in Public Health, 1-13. https://doı: 10.1080/19371918.2021.1986450
• 24. Cameron, E.E, Joyce, K.M, Delaquis, C.P, Reynolds, K, Protudjer, J.L.P. and Roos, L.E. (2020). “Maternal Psychological Distress & Mental Health Service Use During The COVID-19 Pandemic”. Journal of Affective Disorders, 276, 765-774. https://doı: 10.1016/j.jad.2020.07.081
• 25. McCauley, K., Elsom, S., Muır‐Cochrane, E., & Lyneham, J. (2011). “Midwives and Assessment of Perinatal Mental Health”. Journal of Psychiatric and Mental Health Nursing,18(9), 786-795.
• 26. Aydın, R. and Aktaş, S. (2021). “Midwives' Experiences of Traumatic Births: A Systematic Review And Meta-Synthesis”. European Journal of Midwifery, 5. https://doi:10.18332/ejm/138197
• 27. Aktas, S. and Küçük Alemdar, D. (2018). “An Analysis of The Relationship Between Insomnia-Fatigue Levels of The Mothers and Their Depression and Maternal Attachment Status”. Med Sci Int Med J, 7, 728-32. https://doi: 10.5455/medscience.2018.07.8789
• 28. Alan, H. and Ege, E. (2013). “The Influence of Social Support on Maternal-Infant Attachment in Turkish Society”. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 16 (4), 234-240.
• 29. Palancı Ay, Ö. and Aktaş, S. (2021). “The Effect of Maternal Functional and Postpartum Depression Status on Breastfeeding Self-Efficacy of The Mothers: A Cross-Sectional Study”. Health Care for Women International, 1-15. https://doi: 10.1080/07399332.2021.1973008
• 30. Altay, G. ve Arıkan, D. (2021). “COVID-19 Pandemi Sürecinde Yenidoğanlarda Güvenli Maternal Bağlanma ve Emzirme”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 10 (4), 993-999.
• 31. Ponti, L, Smorti, M, Ghinassi, S, Mannella, P, and Simoncini, T. (2020). “Can a Traumatic Childbirth Experience Affect Maternal Psychopathology and Postnatal Attachment Bond?”. Current Psychology, 1-6. https://doi.org/10.1007/s12144-020-00650-2
• 32. Şahin, B. ve Bayrı Bingöl, F. (2021). “Postpartum Maternal Travmatik Stres ve Bağlanma Arasındaki İlişki”. Psikiyatri Hemşireliği Dergisi, 12 (3), 227-236. https://doı: 10.14744/ phd.2021.57704
• 33. Aktaş, S. (2018). “Multigravidas’ Perceptions of Traumatic Childbirth: Its Relation to Some Factors, The Effect of Previous Type of Birth And Experience”. Medicine Sience, 7 (1), 203-209. https://doi: 10.5455/medscience.2017.06. 8728
• 34. Aktas, S. and Pasinlioğlu, T. (2021). “The Effect of Empathy Training Given to Midwives on The Empathic Communication Skills of Midwives and The Birth Satisfaction of Mothers Giving Birth With The Help of These Midwives: A Quasi‐Experimental Study”. Journal of Evaluation in Clinical Practice, 27 (4), 858-867. https://doi: 10.1111/jep.13523
• 35. Aktaş, S. ve Yılar, Z. (2018). “Annelerin Vajinal Doğumu Tercih Etme Nedenlerinin İncelenmesi: Bir Nitel Araştırma Örneği”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 7 (1), 111-124.