Mothers’ Experiences of Institutional Betrayal During Childbirth and their Postpartum Mental Health Outcomes: Evidence From a Survey of New Mothers in the United States

Abstract

Introduction

The purpose of this descriptive study was to explore the relationship between the experience of institutional betrayal (IB) during childbirth and postpartum mental health.

Methods

Women who had given birth within the last 3 years in the United States as of June 2021 were recruited via Qualtrics to complete an online survey. Participants (N = 588) answered questions about their birth experiences, including adverse medical events and experiences of IB. Multiple logistic regressions examined whether experiencing one or more types of IB was associated with receiving a diagnosis of a postpartum mental health condition, controlling for other theoretically relevant covariates.

Results

More than one-third (39%) of respondents experienced one or more types of IB during childbirth, with a mean (SD) of 1.7 (0.47) and maximum of 2. Experiencing IB increased the odds of a postpartum mental health condition diagnosis by 2.86 (95% CI, 1.63-5.05; P < .001).

Discussion

The findings suggest that experiencing IB may be one mechanism driving negative postpartum mental health outcomes. Health care providers and policymakers should be aware of the role that IB can play in women's birth experiences and consider how strategies to decrease instances of IB during childbirth may improve postpartum mental health.