International Survey of Childbirth-Related Trauma (INTERSECT): the Australian INTERSECT study v1

Giving birth is a significant and transformative event. Many women emerge from their birth feeling empowered, viewing the events as positive and coming out of birth feeling emotionally and physically well. Unfortunately, other women emerge from childbirth feeling traumatised. Global literature indicates between 20 to 50% of women report birth to be psychologically traumatic. Of this, around 4% will develop posttraumatic stress disorder (PTSD) as a result of birth. In Australia, prevalence research indicates between 14% to 45% report a traumatic birth, and between 3 to 6% of these women will go on to develop clinically significant PTSD. Birth trauma and PTSD have deleterious impact on the women, her baby, her family, and society as a whole. Childbirth PTSD is highly comorbid with adverse postpartum outcomes, such as postnatal depression, fear of subsequent births (tokophobia), reduced breastfeeding, poorer child development, and strain on the couple’s relationship. Negative experiences with birthing staff (perceived discrimination) is associated with greater PTSD in global literature. Childbirth PTSD is comparatively understudied in Australia, particularly for women from a rural and remote background. The relationships between childbirth PTSD and adverse postpartum outcomes – tokophobia, intimate partner violence, and discrimination – is not known in Australian women. Deepening understanding of childbirth PTSD and postpartum outcomes will help to inform clinical pathways to potentially prevent or reduce negative effects of birth trauma for women and their families. The objective of the Australian INTERSECT study is study to fill knowledge gaps in childbirth PTSD in the Australian context, while contributing to global knowledge of childbirth PTSD. The INTERSECT (International Survey of Childbirth-Related Trauma) study was developed by Professor Susan Ayers at City University London to study childbirth PTSD in an international context. This protocol describes the Australian INTERSECT study which will explore childbirth PTSD – and key adverse postpartum outcomes - in Australian women. The Australian INTERSECT study will collect cross-sectional survey data on women 6-12 weeks postpartum at various Australian antenatal clinic recruitment sites. The PIs of the Australian INTERSECT study will oversee the Australian research outputs, as part of the ‘INTERSECT Consortium’ of international PIs. The Australian PIs will be responsible for recruiting women, distributing the survey, and uploading data to the project database. The data will contribute to INTERSECT – the international head of the project at City University London.