• Gözde Gökçe İsbİr, Figen İncİ, Murat Bektaş, Pelin Dikmen Yıldız, and Susan Ayers.
• School of Health, Nigde University, Nigde, Turkey.
• Midwifery. 2016 Oct 1; 41: 96-103.

Objectivethis study examined factors associated with symptoms of post-traumatic stress (PTS) following childbirth in women with normal, low-risk pregnancies in Nigde, Turkey.Designa prospective longitudinal design where women completed questionnaire measures at 20+ weeks' gestation and 6-8 weeks after birth.Settingeligible pregnant women were recruited from nine family healthcare centres in Nigde between September 2013 and July 2014.Participantsa total of 242 women completed questionnaires at both time points.MeasuresPTS symptoms were measured using the Impact of Event Scale-Revised (IES-R) 6-8 weeks after birth. Potential protective or risk factors of childbirth self-efficacy, fear of childbirth, adaptation to pregnancy/motherhood, and perceived social support were measured in pregnancy and after birth. Perceived support and control during birth was measured after birth. Demographic and obstetric information was collected in pregnancy using standard self-report questions.FindingsPTS symptoms were associated with being multiparous, having a planned pregnancy, poor psychological adaptation to pregnancy, higher outcome expectancy but lower efficacy expectancy during pregnancy, urinary catheterization during labour, less support and perceived control in birth, less satisfaction with hospital care, poor psychological adaptation to motherhood and increased fear of birth post partum. Regression analyses showed the strongest correlates of PTS symptoms were high outcome and low efficacy expectancies in pregnancy, urinary catheterization in labour, poor psychological adaptation to motherhood and increased fear of birth post partum. This model accounted for 29% of the variance in PTS symptoms.Conclusionsthis study suggests women in this province in Turkey report PTS symptoms after birth and this is associated with childbirth self-efficacy in pregnancy, birth factors, and poor adaptation to motherhood and increased fear of birth post partum.Implications For Practicematernity care services in Turkey need to recognise the potential impact of birth experiences on women's mental health and adaptation after birth. The importance of self-efficacy in pregnancy suggests antenatal education or support may protect women against developing post partum PTS, but this needs to be examined further.Copyright © 2016 Elsevier Ltd. All rights reserved.

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