A longitudinal study exploring the role of adult attachment in relation to perceptions of pain in labour, childbirth memory and acute traumatic stress responses

Abstract

Objective: To investigate if adult attachment patterns, measured before childbirth, are predisposing factors for the experiences of childbirth pain and disorganised memory patterns. In addition, we aimed to investigate relationships between these variables and acute symptoms of traumatic stress following childbirth. Background: In 2006, Slade proposed a model for understanding the development of post-traumatic symptoms following childbirth, suggesting consideration of predisposing, precipitating and maintaining internal, external and interactional factors. This study investigated whether adult attachment patterns are a potential predisposing factor by examining associations with other factors in the Slade model: perceived pain and support during birth, and memory processing after birth. Method: Eighty-one nulliparous women were recruited in late pregnancy and completed a questionnaire, including an adult attachment measure. Shortly after childbirth, participants reported on their childbirth experience, concerning perceived pain, perceived staff support memory variables and symptoms of acute traumatic stress. Results: Higher scores on anxious adult attachment were associated with higher pain severity ratings. Higher scores on avoidant attachment were related to participants reporting feeling less respected by staff. However, no relationships between attachment and memory disorganisation were found. Less secure adult attachment was associated with greater acute traumatic stress symptoms of hyperarousal. Conclusion: The findings indicate a possible association between adult attachment and the experience of pain in childbirth. It partially supports previous work demonstrating links between attachment and acute stress symptoms postpartum.

Keywords:

• childbirth
• attachment
• psychological
• pain
• memory

Acknowledgements

Thanks go to all the women who took part in the study, and to the midwives running the antenatal classes at Jessop’s Wing in Sheffield Teaching Hospitals NHS Foundation Trust and at Harrogate District Hospital. Thank you to Claire Isaac at Sheffield University and Helen Baston at Sheffield Teaching Hospitals NHS Foundation Trust for their consultation and advice on this study.