BACKGROUND: Little is known about the influencing factors of psychological birth trauma (PBT) among postpartum women in China. METHODS: A multicenter cross-sectional survey was conducted from April to June 2023 among 2230 women within one year postpartum by convenience sampling. The measurement tools were selected based on the classical ABC-X model. PBT (factor X) was assessed using the Psychological Birth Trauma Assessment Scale. Data on predictors were collected from three aspects, including birth events (factor A), women's coping resources (factor B), and perception of birth events (factor C). Univariate analysis, correlation analysis, and multivariate linear regression analysis were performed to identify the influencing factors of PBT. RESULTS: Multivariate linear regression analysis results showed that induced labor onset (β' = 0.086, P <
.001), preterm birth (β' = 0.049, P = .001), instrumental vaginal delivery (β' = 0.031, P = .039), neuroticism (β' = 0.229, P <
.001), and negative cognitions of birth events (β' = 0.375, P <
.001) were risk factors for PBT among postpartum women in China. Perceived social support (β' = -0.175, P <
.001) and nursing support (β' = -0.117, P <
.001) were protective factors. These factors accounted for 52.5 % of explained variances in PBT. CONCLUSIONS: Multifaceted influencing factors of PBT were identified based on the ABC-X model. Such efforts seem to provide information for identifying women at high risk of PBT and formulating interventions aimed at preventing or reducing PBT and its associated adverse consequences. Additional well-designed studies are required to validate our findings and deepen the understanding of this topic.