Background

Birth can have a negative impact on the wellbeing of parents in the postpartum period. This critical transition period from birth to one year postpartum remains poorly studied. Mental, physical, and sexual wellbeing are particularly important during this time. Postpartum depression and childbirth-related post-traumatic stress disorder (CB-PTSD) affects approx. 13 and 5% of women, respectively. Regarding physical health, up to 41% of women still have pain related to childbirth six months afterwards. The prevalence of sexual problems affects between 41% to 83% of mothers.

Some individual factors have been linked to postpartum health problems, but it is uncertain if the quality of care during childbirth is also associated with the development of postpartum problemss. While no Swiss population-based study exists, collecting accurate and reliable patient-reported data on mental, physical, sexual health, and quality of life, will provide valuable insights on the impact of childbirth care and guide future policy decisions to improve peripartum care. Our overall goal is to assess maternal and co-parent's health and well-being in the postpartum period.

To achieve this goal, the objectives of the SOCRATES study are as follows:

• to estimate, in both parents, the incidence of mental problems two months postpartum, specifically childbirth-related post-traumatic stress disorder (CB-PTSD).
• to explore the etiology of postpartum maternal mental health problems and identify early predictors such as quality of care during childbirth.
• to assess maternal quality of life up to one year postpartum.
• to describe how parental mental problems identified at two months postpartum may influence maternal wellbeing with a focus on physical and sexual health) at six and twelve months.

Methods

We propose to conduct a national prospective cohort studyacross all cantons of Switzerland. Data for births occurring in Swiss maternity units (N=109) will be included over an approx. three-week period, constituting a representative sample of the population (N=3'200 births), and representing the diversity of quality of care. Information on medical data, provision, and experience of care will be collected at birth. Women who will fill out self-report questionnaires to assess their mental, physical health, and quality of life up to one year after delivery. Patient-reported outcomes will be measured by validated questionnaires at two, six and twelve months. Additionally, a survey will be conducted with maternity units to assess local organisation of care, which could be associated with the quality of care.

Expected results and impact on the field

This national cohort study will provide new knowledge about parents' health and wellbeing up to one year postpartum, which will help to improve perinatal health provision and policies. We will identify quality-of-care-related factors that impact parental health and wellbeing after childbirth and recommend evidence-based measures to improve quality of care and maternity care organisation. This study will address the lack of a reliable perinatal health indicator system and national population-based data in Switzerland by providing a representative sample which can be used for further research.