Resilience as a Protective Factor Against Obstetric Violence and Adverse Childhood Experiences in the Perinatal Mental Health of Women

Introduction: Exposure to Adverse Childhood Experiences (ACEs) has been linked to poorer mental health outcomes across the lifespan, with potential exacerbation during the perinatal period. Obstetric violence (OV), defined as disrespectful or non-consensual care during childbirth, may further increase vulnerability. Objective: To examine associations between ACEs, OV, and resilience and explore whether resilience acts as a protective factor for perinatal mental health.

Methods: A cross-sectional online survey was administered using convenience sampling. Inclusion criteria were as follows: being 18 years or older, having given birth within the previous 12 months, and having Spanish nationality. A minimum sample size of 543 participants was required to detect small correlations (r ≈ .12) with α = .05 and 80% power; the final sample exceeded this threshold. A total of 848 participants (M_age = 34.29; SD = 4.05) completed validated measures: the Adverse Childhood Experiences Questionnaire (ACEQ), the Obstetric Violence Scale (EVO), and the abbreviated Connor–Davidson Resilience Scale (CD-RISC). The primary outcomes were ACEs and OV, with resilience examined as a protective variable. Data were analyzed with descriptive statistics and Pearson correlations using SPSS v.28.

Results: Significant ACEs were reported by 11.67% of participants. OV scores were relatively low (M = 21.45; SD = 10.43), and 65.45% showed high resilience. Resilience was negatively correlated with ACEs (r = –.12, p ≤ .001) and OV (r = –.18, p ≤ .001). ACEs and OV were positively correlated (r = .16, p ≤ .001).

Conclusions: ACEs appear to increase vulnerability to OV experiences in the perinatal period, while resilience may buffer the psychological impact of both. These findings highlight the importance of promoting resilience and addressing early adversity to support maternal mental health.