Depression Clinical Trial
Official title:
Childhood Sexual Abuse, Vaginismus and Labor Dystocia: Towards a Theoretical Model
The study aims to develop a theoretical model explicating the inter-relationships between
Childhood Sexual Abuse (CSA), Partial Vaginismus (PV) and Labor Dystocia (LD), including
their associations with Depression (D) as a mediating variable.
The following research hypotheses will be tested:
1. CSA will serve as a risk factor for D, PV and LD.
- pregnant women with a history of CSA will have higher levels of D compared to
pregnant women without a history of CSA.
- pregnant women with a history of CSA will have more PV compared to pregnant women
without a history of CSA.
- pregnant women with a history of CSA will have higher levels of LD compared to
pregnant women without a history of CSA.
2. D will serve as a mediator between prenatal PV and LD.
3. PV will serve as a risk factor for LD.
4. postpartum PV will be affected by childbirth (LD vs. no LD) contingent on the level of
D.
Previous studies indicate that childhood sexual abuse has long term implications to women's
psychological and physical well-being; among them, depression, a plethora of gynecological
symptoms and labor dystocia. Literature in the field also suggests that childhood sexual
abuse may be a contributing factor to total and/or partial vaginismus: psycho-sexual
disorders associated with significant difficulty and pain during attempted penetration,
pelvic examinations and/or sexual relations.
The proposed quantitative longitudinal study aims to develop a theoretical model explicating
the relationships between: childhood sexual abuse, prenatal and postpartum partial
vaginismus, and childbirth (labor dystocia versus no labor dystocia); including their
associations with depression as a mediating variable. Questionnaire responses of pregnant
women (Hebrew/Arabic speakers) from the Hillel-Yaffe medical center in Israel will be
included in the study.
Data collection will be extended across three time periods: prenatal (third trimester of
pregnancy), within one month postpartum, and approximately six months postpartum. Study
questionnaires will probe participant's socio-demographic and gynecological history,
traumatic life events, sexual experiences, level of depression, partial vaginismus and
sexual distress and the objective and subjective severity of their childbirth experience.
Simulations for this project were carried out to help set statistical significance goals and
to determine the sample size needed to achieve these goals. From these simulations, a sample
size of N=2000 was determined to be adequate and cost effective, to determine standard
deviations SD (defining confidence interval ±SD) of about 0.022 for the correlations.
The potential significance of the study is twofold: Theoretically, the study represents a
first of its kind effort to explore the relationships between child sexual abuse, prenatal
and postpartum partial vaginismus, childbirth and depression, in a single comprehensive
longitudinal research study. Practically, the study may potentially assist a wide range of
health care professionals by:
1. providing a developing theory for evidence-based practice.
2. showing the need for integration of women's past history into prenatal and postnatal
care as a means of lowering the risk for a traumatic birth experience and later
psychological distress.
3. aiding in the development of intervention models for the treatment of women with a
history of child sexual abuse and/or vaginismus during pregnancy and childbirth.
;
N/A
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