{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T07:22:12Z","timestamp":1790839332348,"version":"4.1.0"},"reference-count":48,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T00:00:00Z","timestamp":1619568000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This study aimed to determine whether there is an association between clinical practices carried out during spontaneous vaginal birth (SVB), or clinical situations that arise during vaginal birth, and the incidence of post\u2010traumatic stress disorder (PTSD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross\u2010sectional study with 839 puerperal women in Spain was conducted. The Perinatal Post\u2010traumatic Stress Disorder Questionnaire (PPQ) was administered online. The relationship between the risk of postpartum PTSD and various intrapartum complications was studied in addition to practices or procedures performed during the intrapartum period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>PTSD (PPQ scores \u226519) was identified in 8.1% (68) of the women who participated. Among the risk factors for PTSD was a concerning intrapartum FHR tracing (adjusted OR: 2.24, 95% CI: 1.07\u20104.66). Other intrapartum practices also put women at risk of PTSD, including the administration of an enema (aOR: 7.01, 95% CI: 2.14\u201023.01), being required to stay lying down throughout the labor and birth (aOR: 5.75, 95% CI: 3.25\u201010.19), artificial amniorrhexis without consent (aOR: 2.28, 95% CI: 1.31\u20103.97), administration of synthetic oxytocin without consent (aOR: 2.18, 95% CI: 1.26\u20103.77), fundal pressure during pushing (aOR: 3.14, 95% CI: 1.72\u20105.73), repeated vaginal examinations performed by different people (aOR: 4.84, 95% CI: 2.77\u20108.47), and manual removal of the placenta without anesthesia (aOR: 3.45, 95% CI: 1.81\u20106.58).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Various intrapartum clinical practices, all related to dehumanized treatment, and intrapartum complications, were associated with an increased risk of PTSD. There is a need to eradicate obstetric mistreatment and to increase access to evidence\u2010informed, respectful care in Spain. Care practitioners need to better appreciate their roles in preventing PTSD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12550","type":"journal-article","created":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T22:52:53Z","timestamp":1619650373000},"page":"406-415","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Obstetric factors associated with postpartum post\u2010traumatic stress disorder after spontaneous vaginal birth"],"prefix":"10.1111","volume":"48","author":[{"given":"Sergio","family":"Martinez\u2010V\u00e1zquez","sequence":"first","affiliation":[{"name":"Department of Nursing University of Jaen  Ja\u00e9n Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juli\u00e1n","family":"Rodr\u00edguez\u2010Almagro","sequence":"additional","affiliation":[{"name":"Department of Nursing Faculty of Nursing of Ciudad Real University of Castilla\u2010La Mancha  Ciudad Real Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9100-1134","authenticated-orcid":false,"given":"Antonio","family":"Hern\u00e1ndez\u2010Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Department of Nursing Faculty of Nursing of Ciudad Real University of Castilla\u2010La Mancha  Ciudad Real Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Delgado\u2010Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Department of Health Sciences University of Jaen  Ja\u00e9n Spain"},{"name":"CIBER de Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Miguel","family":"Mart\u00ednez\u2010Galiano","sequence":"additional","affiliation":[{"name":"Department of Nursing University of Jaen  Ja\u00e9n Spain"},{"name":"CIBER de Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP)  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,4,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31928-7"},{"key":"e_1_2_8_3_1","unstructured":"WHO.Births by caesarean section Data by country. 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