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Psychological Birth Trauma in Adolescents Experiencing an Early Birth

Anderson, Cheryl PhD, RN, CNS; Mccarley, Michelle MSN, RN

MCN: The American Journal of Maternal/Child Nursing: May/June 2013 - Volume 38 - Issue 3 - p 170–176
doi: 10.1097/NMC.0b013e31826f6cad

Purpose: To explore and compare associations among demographics, childbirth-related stressors, depressive symptoms, gestational age, and psychological birth trauma (PBT) among adolescents.

Study Design and Methods: This cross-sectional, descriptive, comparative study compared two groups of adolescents for PBT. From a larger study dataset, we identified all adolescents delivering prior to 38 weeks (n = 30) and randomly selected 30 adolescents delivering between 38 and 42 weeks gestation for comparison. PBT was defined via birth appraisal, assessed by a one-item rating scale, and trauma impact, assessed via the Impact of Event Scale. Surveys, including the Center for Epidemiological Studies-Depression Scale, were completed within 72 hours of birth. We used frequencies and percentages to describe the sample and Chi square, Spearman Rank-Order Correlation, and Pearson's Product Moment Correlation to determine relationships between variables. Chi square and ANOVA statistical tests determined group differences.

Results: Adolescents were primarily Latina, single, primigravidas, and over 16 years of age. Adolescents delivering before 38 weeks experiencing cesarean births reported symptoms of depression and were highest risk for PBT. Additionally adolescents delivering before 38 weeks reported lack of pain control and unsupportive caregivers in labor.

Clinical Implications: Healthcare professionals cognizant of the potential risk factors for PBT can help vulnerable adolescents through caregiver support, adequate pain control in labor, education, and screening and treatment of depressive symptoms. Follow-up postdischarge, especially for high-risk adolescents, should be arranged to monitor for continued, delayed, or remitting symptoms of depression and PBT.

Several psychosocial-demographic variables are associated with psychological birth trauma among adolescents experiencing an early gestational birth.

Cheryl Anderson is an Associate Professor at College of Nursing, University of Texas at Arlington, Arlington, TX. She can be reached via e-mail at

Michelle McCarley, RN is from UT Southwestern University Hospital-St. Paul, Dallas, TX.

This research was supported in part by grants from Sigma Theta Tau International (STTI), Small Grants Awards; Delta Theta Chapter, STTI, the University of Texas at Arlington; the Sharon Davies Memorial Awards, Freedom from Fear; and the Hispanic Center in Nursing and Health, College of Nursing, University of Texas at Arlington

The authors declare no conflict of interest.

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