{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:04:49Z","timestamp":1791821089197,"version":"4.3.4"},"reference-count":31,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Kauno Kolegija Higher Education Institution, Faculty of Medicine, Lithuania"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nursing Reports"],"abstract":"<jats:p>Background\/Objectives: Childbirth, although generally a positive life event, can sometimes be experienced as traumatic, leading to postpartum post-traumatic stress disorder. Emergency caesarean section and operative vaginal delivery are associated with elevated psychological distress, while factors such as lifetime trauma, domestic violence, anxiety, and coping strategies may further increase vulnerability. Methods: This prospective cohort study included 113 postpartum women who delivered via emergency caesarean section (73.5%) or operative vaginal delivery (26.5%) in two tertiary hospitals in Athens, Greece (March\u2013July 2023). Data were collected at three time points: the second postpartum day, six weeks postpartum, and three months postpartum. Descriptive statistics were used to summarize sample characteristics. Chi-square tests were performed for categorical variables and independent sample t-tests for continuous variables. Multivariate logistic regression analyses were conducted to identify predictors of postpartum post-traumatic stress disorder, with results expressed as odds ratios (OR) and 95% confidence intervals (CI). Results: At six weeks postpartum, 14.2% of participants met full diagnostic criteria for P-PTSD. Postpartum post-traumatic stress was strongly associated with higher state and trait anxiety, fewer positive coping strategies, and exposure to domestic violence (lifetime, during pregnancy, and in the past year). Women with traumatic childbirth experiences had a 14.7-fold higher risk of developing P-PTSD. Lifetime trauma, particularly physical or sexual abuse and exposure to disasters, further increased vulnerability. Over the last three months, 50% of those initially diagnosed continued to meet the diagnostic criteria. Multivariate analysis identified traumatic childbirth, state anxiety, and domestic violence during pregnancy as significant predictors of postpartum post-traumatic stress. Conclusions: Postpartum post-traumatic stress is a significant and underestimated consequence of high-risk deliveries. Screening for domestic violence and trauma history during pregnancy, assessing perinatal anxiety, and providing trauma-informed psychological support are critical to reducing maternal psychiatric morbidity and promoting maternal-infant well-being.<\/jats:p>","DOI":"10.3390\/nursrep15120420","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T11:19:51Z","timestamp":1764328791000},"page":"420","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Predictors of Postpartum Post-Traumatic Stress Disorder Following Traumatic Birth: The Influence of Lifetime Trauma, Violence, and Coping Strategies\u2014A Prospective Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7458-7500","authenticated-orcid":false,"given":"Eirini","family":"Orovou","sequence":"first","affiliation":[{"name":"Department of Midwifery, University of Western Macedonia, 50200 Ptolemaida, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3316-8566","authenticated-orcid":false,"given":"Antigoni","family":"Sarantaki","sequence":"additional","affiliation":[{"name":"Department of Midwifery, University of West Attica, Agioy Spyridonos 28, 12243 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3299-9464","authenticated-orcid":false,"given":"Vaidas","family":"Jotautis","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Kauno Kolegija Higher Education Institution, Pramon\u0117s pr. 20, 50468 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2137-2439","authenticated-orcid":false,"given":"Zacharias","family":"Kyritsis","sequence":"additional","affiliation":[{"name":"School of Mathematics, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6051-0860","authenticated-orcid":false,"given":"Maria Tzitiridou","family":"Chatzopoulou","sequence":"additional","affiliation":[{"name":"Department of Midwifery, University of Western Macedonia, 50200 Ptolemaida, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"El-Salahi, S., Knowles Bevis, R., and Hogg, L. 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