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    Risk factors associated with post-traumatic stress symptoms following childbirth in Turkey
    (ELSEVIER SCI LTD, 2016) Isbir, Gozde Gokce; Inci, Figen; Bektas, Murat; Yildiz, Pelin Dikmen; Ayers, Susan
    Objective: this study examined factors associated with symptoms of post-traumatic stress (PTS) following childbirth in women with normal, low-risk pregnancies in Nigde, Turkey. Design: a prospective longitudinal design where women completed questionnaire measures at 20+ weeks' gestation and 6-8 weeks after birth. Setting: eligible pregnant women were recruited from nine family healthcare centres in Nigde between September 2013 and July 2014. Participants: a total of 242 women completed questionnaires at both time points. Measures: PTS symptoms were measured using the Impact of Event Scale-Revised (IES-R) 6-8 weeks after birth. Potential protective or risk factors of childbirth self-efficacy, fear of childbirth, adaptation to pregnancy/motherhood, and perceived social support were measured in pregnancy and after birth. Perceived support and control during birth was measured after birth. Demographic and obstetric information was collected in pregnancy using standard self-report questions. Findings: PTS symptoms were associated with being multiparous, having a planned pregnancy, poor psychological adaptation to pregnancy, higher outcome expectancy but lower efficacy expectancy during pregnancy, urinary catheterization during labour, less support and perceived control in birth, less satisfaction with hospital care, poor psychological adaptation to motherhood and increased fear of birth post partum. Regression analyses showed the strongest correlates of PTS symptoms were high outcome and low efficacy expectancies in pregnancy, urinary catheterization in labour, poor psychological adaptation to motherhood and increased fear of birth post partum. This model accounted for 29% of the variance in PTS symptoms. Conclusions: this study suggests women in this province in Turkey report PTS symptoms after birth and this is associated with childbirth self-efficacy in pregnancy, birth factors, and poor adaptation to motherhood and increased fear of birth post partum. Implications for practice: maternity care services in Turkey need to recognise the potential impact of birth experiences on women's mental health and adaptation after birth. The importance of self-efficacy in pregnancy suggests antenatal education or support may protect women against developing post partum PTS, but this needs to be examined further. (C) 2016 Elsevier Ltd. All rights reserved.
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    The effects of antenatal education on fear of childbirth, maternal self-efficacy and post-traumatic stress disorder (PTSD) symptoms following childbirth: an experimental study
    (W B SAUNDERS CO-ELSEVIER INC, 2016) Isbir, Gozde Gokce; Inci, Figen; Onal, Hatice; Yildiz, Pelin Dikmen
    Background: Fear of birth and low childbirth self-efficacy is predictive of post-traumatic stress disorder symptoms following childbirth. The efficacy of antenatal education classes on fear of birth and childbirth self-efficacy has been supported; however, the effectiveness of antenatal classes on post-traumatic stress disorder symptoms after childbirth has received relatively little research attention. Purpose: This study examined the effects of antenatal education on fear of childbirth, maternal self-efficacy and post-traumatic stress disorder symptoms following childbirth. Design: Quasi-experimental study. Methods: The study was conducted in a city located in the Middle Anatolia region of Turkey and data were collected between December 2013 and May 2015. Two groups of women were compared an antenatal education intervention group (n = 44), and a routine prenatal care control group (n = 46). The Wijma Delivery Expectancy/Experience Questionnaire, Version A and B, Childbirth Self-efficacy Inventory and Impact of Event Scale-Revised was used to assess fear of childbirth, maternal self-efficacy and PTSD symptoms following childbirth. Results: Compared to the control group, women who attended antenatal education had greater childbirth self efficacy, greater perceived support and control in birth, and less fear of birth and post-traumatic stress disorder symptoms following childbirth (all comparisons, p < 0.05). Conclusions: Antenatal education appears to alleviate post-traumatic stress disorder symptoms after childbirth. (C) 2016 Elsevier Inc All rights reserved.