[Validation of the questionnaire for assessing the childbirth experience (QACE) in a French population]

BACKGROUND

A woman's negative perception of her subjective childbirth experience can have consequences on the mother's psychological state and on early mother-baby relationships. To date, there is no validated tool in France allowing to evaluate childbirth experience in a multidimensional way. The aim of this study is to validate the Questionnaire Assessing the Childbirth Experience (QEVA) in a French sample of mothers. This tool was developed in a previous study where the authors combined 25 items into 6 dimensions: representations and expectations, sensory perceptions, feeling of control, perceived social support (medical staff and partner), emotions (positive and negative) and first moments with the baby.

METHODS

The sample included 256 women recruited in a maternity ward. Sociodemographic and obstetric characteristics of our sample were compared to those of the French national perinatal survey. The structure of the QEVA with 17 items was explored by an exploratory structural equation modeling (ESEM). An analysis of the internal consistency was conducted on the sub-scores of the identified factors, and the concurrent validity was assessed with the Peri-traumatic Distress Inventory (PDI) through a correlation and its associated t-test.

RESULTS

The characteristics of our sample and those of the national perinatal survey do not differ on age, marital status, parity, cannabis use, infertility treatment, epidural and baby weight, in favour of the good representativeness of our sample. The study of the QEVA structure revealed a 4-dimensional structure. Analysis of the psychometric qualities showed a good internal consistency, with an observed alpha value ranging from 0.69 to 0.86. The QEVA also shows a good concurrent validity with the peri-traumatic distress scores (r=0.51).

CONCLUSION

To date, the QEVA is the first standardized tool allowing a multidimensional evaluation of the subjective experience of childbirth. It has been validated on a French population using an exploratory structural equation modeling. This tool, which is simple to use and well accepted by mothers, enables health professionals not only to screen mothers experiencing difficult childbirth and in need of support, but also to adapt health care according to the dimensions of the birth experience and its associated difficulties (emotions during the birth, interactions with health professionals, first moments with the baby, or post-partum emotions).

[Determinants of Anxiety Symptoms, Depression and Peri-traumatic Distress in Immediate Postpartum Women's mental health]

OBJECTIVES

The aims of this study were to identify the determinants and the vulnerability factors of women's mental health in the immediate postpartum period by investigating the first symptoms of anxiety, depression and peri-traumatic distress.

METHODS

256 women participated in this cross-sectional and descriptive study. They responded during their stay in the maternity ward to a set of questionnaires between the 1st and the 6th day after delivery. This included an anamnestic questionnaire as well as different scales that evaluated generalized self-efficacy feeling (GSES), marital adjustment (DAS), perceived sense of control during labor and delivery (LAS), birth experience (QEVA), anxiety manifestations (STAI-Y), depressive symptoms (EPDS) and peri-traumatic distress (PDI).

RESULTS

Symptoms of anxiety, depression and peri-traumatic distress in the immediate postpartum period, as indicators of women's mental health, are predicted by different determinants. An anxious personality and perceived complications during childbirth for the woman or baby have been shown to be significant predictors of postpartum anxiety. Symptoms of depression are related to a history of depression, a low overall sense of general efficacy and lower satisfaction in the marital relationship. Peri-traumatic distress is related to certain dimensions of the childbirth experience, such as perceived sense of control, perceived complications and emotions felt during birth.

CONCLUSIONS

Symptoms of depression, anxiety and peritraumatic distress are linked to aspects of the prenatal period, but also to the experience of childbirth. More specific prevention, screening and care measures, depending on the woman's symptomatology, can be implemented during pregnancy or at the maternity. Further research seems essential to better understand the interactions between the prenatal period, childbirth and postpartum in explaining women's mental health in the immediate postpartum period.