{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T20:21:47Z","timestamp":1784060507046,"version":"3.55.0"},"reference-count":42,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T00:00:00Z","timestamp":1726704000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Although the benefits of doula care during childbirth are well\u2010known, its impact on childbirth\u2010related post\u2010traumatic stress disorder (CB\u2010PTSD) symptoms are less thoroughly characterized. This study aimed to explore the association between doula care and CB\u2010PTSD symptoms and the potential mediating role of childbirth experience on this association.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective cohort study was conducted in a hospital in China, enrolling women with singleton live vaginal births. The exposure and primary outcome factors of interest were doula care and CB\u2010PTSD symptoms, with childbirth experience as a mediating factor. Questionnaires were administered to collect baseline data and childbirth experience at 3\u2009days postpartum, and CB\u2010PTSD symptoms from participants at 42\u2009days postpartum. Linear regression analysis was used to analyze the relationship between doula care, childbirth experience, and CB\u2010PTSD symptoms, while the mediating role of childbirth experience was analyzed using the SPSS (PROCESS) modeling tool.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 445 eligible women were included in the final analysis, including 120 who received doula care and 325 who did not. Linear regression analyses found that doula care was independently associated with CB\u2010PTSD symptoms (<jats:italic>\u03b2<\/jats:italic>\u2009=\u2009\u22120.11, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) and childbirth experience (<jats:italic>\u03b2<\/jats:italic>\u2009=\u20090.50, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Childbirth experience was significantly associated with CB\u2010PTSD symptoms (<jats:italic>\u03b2<\/jats:italic>\u2009=\u2009\u22120.17, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Childbirth experience mediated the association between doula care and CB\u2010PTSD symptoms (indirect effect\u2009=\u2009\u22121.08, 95% CI \u22121.91 to \u22120.10), even after adjusting for potential confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Childbirth experience serves as a mediator of the association between doula care and CB\u2010PTSD symptoms. By providing supportive care for women during childbirth, their childbirth experience could be improved, thereby reducing the risk of CB\u2010PTSD symptoms.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12874","type":"journal-article","created":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T14:01:20Z","timestamp":1726754480000},"page":"243-251","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The Association Between Doula Care and Childbirth\u2010Related Post\u2010Traumatic Stress Disorder Symptoms: The Mediating Role of Childbirth Experience"],"prefix":"10.1111","volume":"52","author":[{"given":"Xiaolu","family":"Lai","sequence":"first","affiliation":[{"name":"School of Nursing Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingfen","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Nursing Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Demei","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Foshan Women and Children Hospital  Foshan Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Foshan Women and Children Hospital  Foshan Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiafen","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Foshan Women and Children Hospital  Foshan Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Innie","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Epidemiology and Public Health, Faculty of Medicine University of Ottawa  Ottawa Ontario Canada"},{"name":"Ottawa Hospital Research Institute  Ottawa Ontario Canada"},{"name":"Department of Obstetrics &amp; Gynecology, Faculty of Medicine University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Krewski","sequence":"additional","affiliation":[{"name":"School of Epidemiology and Public Health, Faculty of Medicine University of Ottawa  Ottawa Ontario Canada"},{"name":"McLaughlin Centre for Population Health Risk Assessment University of Ottawa Faculty of Medicine  Ottawa Ontario Canada"},{"name":"Risk Science International  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7227-0283","authenticated-orcid":false,"given":"Shi Wu","family":"Wen","sequence":"additional","affiliation":[{"name":"School of Epidemiology and Public Health, Faculty of Medicine University of Ottawa  Ottawa Ontario Canada"},{"name":"Ottawa Hospital Research Institute  Ottawa Ontario Canada"},{"name":"Department of Obstetrics &amp; Gynecology, Faculty of Medicine University of Ottawa  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3023-5412","authenticated-orcid":false,"given":"Ri\u2010hua","family":"Xie","sequence":"additional","affiliation":[{"name":"School of Nursing Southern Medical University  Guangzhou China"},{"name":"Women and Children Medical Research Center, Department of Nursing Foshan Women and Children Hospital  Foshan Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,19]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2014.03.011"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2021-067659","article-title":"Identifying Post\u2010Traumatic Stress Disorder After Childbirth","volume":"377","author":"Slade P.","year":"2022","journal-title":"BMJ"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2017.00560"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2023.09.089"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2020.113090"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10030488"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14643"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291715002706"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2012.01476.x"},{"issue":"7","key":"e_1_2_10_12_1","article-title":"Continuous Support for Women During Childbirth","volume":"7","author":"Bohren M. 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