# Traumatic birth experiences and maternal caregiving behaviors and attitudes in black and white women

## TL;DR

This study explores how traumatic birth experiences affect maternal caregiving behaviors in Black and White women, finding a surprising positive link at one year postpartum.

## Contribution

The study is the first to focus on Black women's childbirth experiences and caregiving behaviors, addressing a gap in underrepresented populations.

## Key findings

- More traumatic birth experiences were significantly associated with higher positive parenting scores at 12 months postpartum.
- There were no significant race-related differences in the relationship between childbirth trauma and caregiving behaviors.
- Most associations between childbirth trauma and caregiving behaviors were nonsignificant at other timepoints.

## Abstract

This longitudinal investigation examined the association between traumatic birth experiences (measured via self-report and clinician-report) and caregiving behaviors and attitudes and any race-related differences in these associations.

Subjective childbirth trauma was measured via a three-item questionnaire at 12 weeks postpartum. Medical childbirth factors were extracted from the electronic health record. Maternal caregiving behaviors and attitudes were assessed via comprehensive questionnaires (i.e., mother-infant bonding and parenting stress) and observation ratings (i.e., positive parenting and mother-infant interactions) at 12 weeks, 12 months, and 24 months postpartum. Multiple linear regressions were run to analyze these relationships.

A total of 255 mothers (106 Black and 149 White) who gave birth from April to December 2020 were examined. More traumatic childbirth experiences were significantly associated with higher-rated observed positive parenting scores (β = 0.21, pFDR<0.05) when controlling for demographic factors. There were no significant relationships at 12 weeks or 24 months postpartum. Additionally, there were no effects of race on the relationship between childbirth trauma and caregiving.

Subjective reports of childbirth trauma were not significantly associated with poorer maternal caregiving behaviors and attitudes. This study adds to the literature by examining Black women, as they are underrepresented in this body of research and more at risk of experiencing traumatic childbirths.

The online version contains supplementary material available at 10.1007/s00737-026-01682-6.

This study investigated the relationship between childbirth trauma and various maternal caregiving behaviors, measured at several timepoints during the postpartum period. The sample included Black and White women who gave birth early in the COVID-19 pandemic, a time of heightened stress for those delivering in a hospital setting.

We found mostly nonsignificant relationships but one positive relationship between childbirth and caregiving behaviors when children were 12 months old: More traumatic birth experiences were related to better caregiving scores.

This is the first study to focus on Black individuals’ childbirth experiences and its relation to caregiving behaviors. More research is needed on women of color, as they have a higher risk of experiencing a traumatic birth.

The online version contains supplementary material available at 10.1007/s00737-026-01682-6.