Psychological childbirth trauma and its relation to the childbirth experience in Iranian women: a cross-sectional study

Childbirth is one of the most important and complex events in a woman’s life, which can greatly impact her psychological, physical, and social well-being. Psychological trauma related to childbirth describes a mental and emotional experience where a woman perceives the process as a serious threat to her own or her baby’s health, often with feelings of powerlessness, loss of control, and lack of support from medical staff. Although considerable attention is given to childbirth’s physical and physiological aspects, its psychological dimensions often receive less focus. This study aims to assess the prevalence of psychological childbirth trauma and its relationship with the childbirth experience in Iranian women. This cross-sectional study involved 311 women between 6 and 8 weeks postpartum who had medical records at health centers in Tabriz, Iran. Participants were recruited using a cluster sampling approach. Data were gathered through a socio-demographic characteristics questionnaire, the Birth Trauma Scale (BTS), and the Childbirth Experience Questionnaire 2.0 (CEQ2.0). To explore the relationship between BTS and CEQ2.0, a Pearson correlation test was used for bivariate analysis, while a general linear model adjusted for socio-demographic characteristics was applied for multivariate analysis. The mean (SD) total childbirth experience score was 2.77 (0.54) within the possible score range of 1 to 4, and the mean (SD) psychological childbirth trauma score was 35.02 (12.27) on a scale of 15 to 75. Pearson correlation analysis showed a significant negative correlation between psychological childbirth trauma and overall childbirth experience (r = − 0.64, p < 0.001), as well as with its dimensions including personal capacity, participation, perceived safety, and professional support (all p < 0.001). In the adjusted general linear model, higher psychological trauma scores were independently associated with lower childbirth experience scores (β = −0.027; 95% CI: −0.031 to − 0.023; p < 0.001). The presence of a doula was associated with higher childbirth experience scores, while giving birth in a public hospital was associated with lower scores. The findings emphasize the importance of identifying women at risk of psychological trauma during childbirth, creating supportive interventions, enhancing midwifery care, and ensuring a doula’s presence to improve the childbirth experience. These insights can form a foundation for effective policy development.