Lingling Li,1,* Lanlan Xiao,1,* Jie Wu,2 Jinxiao Li,1 Xiuping Chen,3 Bei Wang4 

1Department of Obstetrics and Gynecology, Second Affiliated Hospital of Naval Medical University, Shanghai, 200003, People’s Republic of China; 2Department of Nursing, Shanghai Jiading District Maternal and Child Health Care Hospital, Shanghai, 201821, People’s Republic of China; 3Department of Obstetrics and Gynecology, Huashan Hospital, Fudan University, Shanghai, 201907, People’s Republic of China; 4Department of Nursing, Second Affiliated Hospital of Naval Medical University, Shanghai, 200003, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Bei Wang, Department of Nursing, Second Affiliated Hospital of Naval Medical University, No. 415 Fengyang Road, Huangpu District, Shanghai, 200003, People’s Republic of China, Email 15800567451@163.com Xiuping Chen, Department of Obstetrics and Gynecology, Huashan Hospital, Fudan University, No. 415 Fengyang Road, Huangpu District, Shanghai, 201907, People’s Republic of China, Email 269027076@qq.com

Objective: Birth trauma affects 9% to 44% of postpartum women and significantly impacts maternal health. In China, changes in social structures have led to discrepancies between expected and actual social support, yet few studies have explored the relationship with birth trauma. This study examines the association between birth trauma symptoms at 42 days postpartum and the gap between expected and received social support.
Methods: A total of 204 postpartum women were recruited from four hospitals in Shanghai between January and March 2024. Participants completed the Chinese City Birth Trauma Scale and the Postpartum Social Support Scale. Pearson’s correlation and multiple linear regression analyses were used to evaluate associations between trauma symptoms and the social support expectation gap.
Results: Among the participants, 52.5% (107/204) were diagnosed with birth trauma. The mean trauma score was 45.01 ± 16.48. Actual social support was significantly negatively correlated with trauma symptom severity (r = – 0.426 to – 0.053, all P < 0.05), whereas the gap between expected and received support showed a significant positive correlation (r = 0.145 to 0.281, all P < 0.05). Emotional and informational support gaps had the strongest associations. Multiple linear regression further confirmed that lower household income (β = 0.171, P = 0.015), educational level below college (β = 0.282, P < 0.001), and formula feeding (β = 0.179, P = 0.010) were independent predictors of more severe birth trauma symptoms.
Conclusion: Birth trauma symptoms are common at 42 days postpartum. Significant associations were observed between higher trauma scores and both inadequate actual support and larger expectation gaps—especially in emotional and informational domains. Bridging these gaps, particularly among women of lower socioeconomic status, may help reduce psychological trauma and improve postpartum recovery.

Keywords: postpartum women, birth trauma, social support, expectation gap