{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T07:53:50Z","timestamp":1790927630355,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Psychological birth trauma (PBT) is a significant maternal health concern characterized by fear, helplessness, and loss of control during childbirth. While continuous labor companion support, women\u2010centered care, and childbirth readiness are individually associated with improved maternal outcomes, their cross\u2010sectional statistical association with reported levels of PBT remain underexplored. This study aimed to examine the associations between these variables among postnatal women in Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A facility\u2010based cross\u2010sectional study was conducted among 440 postnatal women in Addis Ababa. Participants were selected using systematic random sampling. Data were collected using validated tools: the Birth Trauma Scale, Childbirth Readiness Scale, Person\u2010Centered Maternity Care scale, and Birth Companion Support Questionnaire. All instruments were translated into Amharic using forward\u2013backward translation. While internal consistency was high (Cronbach's alpha\u2009&gt;\u20090.80), formal psychometric validation in Amharic has not been previously published, which introduces potential unmeasured variance in construct validity and measurement equivalence, and is acknowledged as a key analytical limitation. Structural Equation Modeling (SEM) with Weighted Least Squares Mean and Variance (WLSMV) estimation was applied. Indirect association analysis was performed using SEM and 5000 bias\u2010corrected bootstrap samples. Model fit was assessed using\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \/df, CFI, TLI, RMSEA, and SRMR. All analyses, including SEM pathways, were conducted using two\u2010tailed tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 431 postnatal women (98.0% response rate; mean age\u2009=\u200929.0, SD\u2009=\u20094.86), continuous labor companion support was directly and inversely associated with psychological birth trauma levels (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.31, 95% CI [\u22120.50, \u22120.14],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Statistically significant indirect association connected companion support to lower birth trauma via childbirth readiness (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.03, 95% CI [\u22120.098, \u22120.011],\n                      <jats:italic>q<\/jats:italic>\n                      \u2009=\u20090.013) and person\u2010centered maternity care (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u2009\u22120.108, 95% CI [\u22120.111, \u22120.022],\n                      <jats:italic>q<\/jats:italic>\n                      \u2009=\u20090.002). The final SEM model showed excellent fit indices (\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \/df\u2009=\u20093.446, CFI\u2009=\u20090.950, RMSEA\u2009=\u20090.071, SRMR\u2009=\u20090.056) with path coefficients reported as standardized estimates (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Continuous labor companion support was significantly associated with lower reported psychological birth trauma, with statistical indirect relationships co\u2010occurring with higher levels of childbirth readiness and person\u2010centered care. These findings should be interpreted solely as correlational associations; causal inference requires longitudinal or intervention designs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.73028","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T05:00:48Z","timestamp":1786683648000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Labor Companion Support, Women\u2010Centered Care, and Childbirth Preparation in Relation to Psychological Birth Trauma: A Cross\u2010Sectional SEM Analysis"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6873-501X","authenticated-orcid":false,"given":"Gedamu Abera","family":"Zegeye","sequence":"first","affiliation":[{"name":"Department of Midwifery, College of Health Sciences Mekelle University Mekelle Ethiopia"},{"name":"Department of Population and Family Health, Public Health faculty, Institute of Health Jimma University Jimma Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muluemebet Abera","family":"Wordofa","sequence":"additional","affiliation":[{"name":"Department of Population and Family Health, Public Health faculty, Institute of Health Jimma University Jimma Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0707-4363","authenticated-orcid":false,"given":"Afework","family":"Mulugeta","sequence":"additional","affiliation":[{"name":"School of Public Health, College of Health Sciences Mekelle University Mekelle Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2022.1065612"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-022-04377-9"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006199-200407000-00004"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/03630242.2021.1927287"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/02646838.2020.1788210"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0258696"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1524838020977161"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.4324\/9780203766699"},{"issue":"3","key":"e_1_2_13_10_1","article-title":"The Effect of Counseling on Anxiety After Traumatic Childbirth in Nulliparous Women; 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