Validation of the City Birth Trauma Scale in Italian: addressing childbirth-related posttraumatic stress disorder

Background and aim: It is estimated that 19% of women experience childbirth as traumatic, and around 4% develop post-traumatic stress disorder (PTSD) as a result. The City Birth Trauma Scale was developed specifically to assess childbirth-related trauma according to recognised diagnostic criteria. This study aimed to translate and validate the City Birth Trauma Scale in Italian (City BiTS-IT) and investigate its psychometric properties to enhance early detection and intervention. Methods: The sample consisted of 255 postpartum women aged 18–38 years. Participants completed the INTERSECT Survey which includes the City Birth Trauma Scale (City BiTS). The bi-factor model was applied to assess the latent structure of the scale, and convergent and divergent validity were evaluated. Results: The City BiTS-IT demonstrated good fit to the data, with high internal consistency (ω = 0.93) and reliability (ECV = 51%). Subscales of Birth-related symptoms and General symptoms showed good reliability (ω = 0.90, ω = 0.89, respectively). Convergent validity analyses revealed strong correlations between City BiTS-IT and depression (EPDS; r = 0.59). Birth-related symptoms correlated more strongly with birth satisfaction scores (BSS-R; r = -0.68), highlighting the impact of traumatic birth experiences on maternal satisfaction. The prevalence of childbirth-related PTSD was 2.4%. Conclusion: The validation of the City BiTS-IT provides a valuable tool for healthcare professionals in Italy to identify and intervene early in cases of CB-PTSD. Future research should focus on longitudinal studies to understand the progression of CB-PTSD symptoms and develop tailored interventions for at-risk populations.