Traumatic birth experience has undesirable effects on the life of the mother, child, family, and society. The identification of predictive factors can be useful in improving birth experiences among ...women. This study aimed to assess the prevalence of a traumatic birth experience and identify its predictors among a group primiparous women.
A cross-sectional study was conducted among 64 health centres in Tabriz, the second largest city in Iran. Cluster sampling was used to recruit 800 eligible women at one to 4 months postpartum. The Persian version of the Childbirth Experience Questionnaire was used to measure the womens' birth experiences. Data were collected through face to face interviews and analysed mainly by multivariable logistic regression.
The prevalence of traumatic birth experience was 37% in the study group. The independent predictors of the traumatic birth experience were related to antenatal and intrapartum factors. The antenatal predictor was the lack of exercise during pregnancy (OR = 2.81, CI 1.40-5.63, P = .003) and the intrapartum predictors were the absence of pain relief during labour and birth (OR = 4.24, CI 2.12-8.50, P < .001), and the fear of childbirth (OR = 3.47, CI 1.68-7.19, P < .001).
The findings revealed the high rate of traumatic birth experience among the primimarous women and identified the importance of a woman-centered care where a woman can actively make decision about the care she receives receive during labour and birth.
A significant number of women experience childbirth as traumatic. These experiences are often characterized by a loss of control coupled with a perceived lack of support and inadequate communication ...with health care providers. Little is known about the choices women make in subsequent pregnancy(s) and birth(s), or why they make these choices. This study aimed to understand these choices and explore the reasons behind them.
A longitudinal grounded theory methods study involving nine women was conducted. Over half of the participants had a formal diagnosis of post-traumatic stress disorder (PTSD) and/or PND related to the previous birth. Interviews were carried out at three timepoints perinatally. These findings are from the first interviews at 12-20 weeks.
From the first days of pregnancy, this cohort of women were focused on concerns that this birth would be a repeated traumatic experience. The women were deliberately searching out and analyzing information about their choices in this pregnancy and birth, and making plans which had two aims; firstly to avoid a repeat of their previous birth experience and secondly to avoid a loss of control to other people during the birth. The women considered a range of birth choices, from elective cesareans to freebirth. Some women felt well supported by those around them, including care providers, partners, friends, and family. Others did not feel supported and were anticipating conflict in trying to assert their birth choices. Many early relationships with healthcare professionals were characterized by fear and mistrust.
If women who have previously experienced a traumatic birth become pregnant again, they have a strong desire to avoid a repeat experience and to feel in control of their birth choices. Access to robust information appears to help reduce uncertainty and arm women in their discussions with professionals. Similarly making plans and seeking to have them agreed with care providers at an early stage is used a way to reduce the risk of having a further traumatic experience. Implications for practice include supporting women in formulating and confirming pregnancy and birth plans at an early stage to reduce uncertainty and foster a sense of control.
Framed by relational dialectics theory, the current investigation sought to understand women's meaning making processes in publicly shared stories about birth trauma. Contrapuntal analysis was used ...to identify culturally dominant systems of meaning embedded in women's talk about traumatic birth. Forty-one stories recounting traumatic births were analyzed within a variety of contexts (e.g., natural birth, cesarean, preemie). The dominant discourse of traumatic birth as incongruent with intensive motherhood informed much of women's communication about traumatic birth. Discursive interplay was also identified through the struggle between the discourse of traumatic birth as incongruent with intensive motherhood and the discourse of individualism.
This study examines the relationship between birth memory and recall and the perception of traumatic birth in women who were a postpartum one-year period and the affecting factors. This descriptive ...and correlational study was conducted with 285 participants in the pediatric department of a state university medical school. Data were collected using a participant information form, Birth Memories and Recall Questionnaire, and Perception of Traumatic Childbirth Scale. In the study, it was determined that the women had a moderate level of birth memories and recall, and the rate of those with a “high” and “very high” perception of traumatic childbirth was 45.9%. According to path analysis, Birth Memories and Recall Questionnaire score and educational status (primary secondary school) have a positive and significant effect on the perception of traumatic birth. The perception of traumatic birth was a predictor that explained 17.3% of birth memories and recall. Nearly half of the study participants perceived the experience of giving birth as traumatic, and birth memories and recall were at a moderate level. Improving women’s perception of education and traumatic birth will contribute to positive birth memories and to create positive emotions when they remember their birth.
Background: Traumatic births are considered as challenging events in the professional life of midwives. Negative emotional and psychological consequences of these births on midwives are ...well-established. However, evidence suggests that in the aftermath of challenging events, such as birth traumas, positive outcomes may emerge as well. Based on the literature, shoulder dystocia (SD) is known as one of the most traumatic birth experiences for midwives. In this study we aimed to explore the impact of experiencing SD complicated births on clinical practice of midwives.
Methods: A qualitative descriptive study was undertaken. Midwives who had an experience of at least one case of SD were invited to the study through the Australian College of Midwives. In-depth interviews were conducted with 25 midwives. Data were analysed using an inductive thematic approach.
Results: Three themes were identified 1) Putting on a brave face 2) Towards the growth zone 3) I am resilient enough to recover, because of …. Experience of SD was described as a dreadful event in midwives’ career. However, on reflection, this experience was considered as a benefit which developed midwives’ clinical expertise and contributed to their professional empowerment. Having faith in birth normality, support from workplace, seniority/ years of experience and self-confidence were among the factors which helped midwives in overcoming the stress after SD.
Conclusion: There needs to be greater awareness about the consequences of traumatic births such as SD for midwives. Collegial support has a critical role in helping midwives to have a positive outlook on their traumatic experience and to ease their pathway of professional growth.
Background: The research was carried out to examine the effect of a parenting preparation course given to midwifery students during an academic semester on the preferred mode of delivery, fear of ...childbirth, and traumatic birth perception. Methods: This was a quasi-experimental study with a pretest-posttest design that included 47 second-year students enrolled in the parenting preparation course. Students took the parenthood preparation course, 2 hours a week, for 14 weeks. Data were collected using a descriptive information form, the pre-pregnancy fear of birth scale, and the perception of traumatic birth scale. Paired t-test and chi-square test were used to evaluate intragroup and intergroup differences. The data were analyzed using SPSS 22.0 software at a statistical significance of 0.05. Results: The mean age of the students was 20.13±0.67 years. The mean score of pre-pregnancy fear of childbirth was 40.46±9.37 in the pretest and 23.61±6.79 in the posttest. In addition, the mean score of traumatic childbirth perception decreased from 77.34±25.15 in the pretest to 39.44±13.78 in the posttest. The number of students who preferred cesarean section decreased significantly, while the number of students who preferred vaginal delivery increased after the preparation course. Conclusion: Parenting preparation classes can contribute to the reduction of fear of childbirth and the perception of traumatic childbirth in women.
To examine the relationship between the perception of traumatic birth and maternal attachment in pregnant women.
This descriptive and correlational study recruited 370 pregnant women who applied for ...an antenatal visit to outpatient clinics of a state hospital. The data were collected using a Personal Information Form, Maternal Antenatal Attachment Scale (MAAS), and Traumatic Birth Perception Scale (TBPS). Data were collected using the face-to-face method. The study was reported according to the STROBE.
The mean total score of MAAS was 75.71 ± 7.72 and the mean TBPS score was 73.21 ± 28.34. Normal birth pain was perceived as "severe" by 38.3% of pregnant women and as "very severe" by 46.1%. It was determined that 29.2% of pregnant women had a "high" level of traumatic birth perception and 14.5% had a "very high" level. A negative correlation was found between the mean scores of MAAS and TBPS of pregnant women. The trimester of pregnancy, listening to the birth story, planned pregnancy, and traumatic birth perception, was a significant predictor of maternal antenatal attachment.
As the maternal antenatal attachment levels of pregnant women increased, their perceptions of traumatic birth decreased.
OBJECTIVESTo establish the prevalence and correlates of a subjectively traumatic birth experience in an Irish maternity sample. DESIGNA questionnaire routinely provided to all women prior to hospital ...discharge post-birth was amended for data collection for this study. Two additional questions seeking information about women's perceptions of their birth were added and analysed. Women who described their birth as traumatic and agreed to follow-up, received a City Birth Trauma Scale (Ayers et al., 2018) at subsequent follow-up (6 to 12 weeks postpartum). Demographic, obstetric, neonatal variables and factors associated with birth trauma were collected from electronic maternity records retrospectively. SETTINGA postnatal ward in an Irish maternity hospital which provides postnatal care for public maternity patients. PARTICIPANTSPostpartum women (N=1154) between 1 and 5 days postpartum. MEASUREMENTS & FINDINGSParticipants completed the Edinburgh Postnatal Depression Scale (EPDS) (Cox et al., 1987) with two additional questions about birth trauma. Eighteen percent (n=209) of women reported their birth as traumatic. Factors associated with reporting birth as traumatic included a history of depression, raised EPDS scores (>12), induction of labour, combined ventouse/forceps birth, and postpartum haemorrhage. Of these 209 women, 134 went on to complete the City Birth Trauma Scale (Ayers et al., 2018). The average score was 3.84 and 6 of this sample (4%) reached the threshold for postpartum post-traumatic stress disorder (PTSD). KEY CONCLUSIONSThis study identified a prevalence of 18% of women experiencing birth as traumatic and the potentially important role of a current and past history of depression, postpartum haemorrhage, induction of labour and operative vaginal birth in defining a traumatic birth experience. The majority of women were resilient to birth trauma, few developed PTSD , but a larger cohort had significant functional impairment associated with sub-clinical postpartum PTSD symptoms. IMPLICATIONS FOR PRACTICEMaternity care providers should be aware of the risk factors for traumatic birth. Introducing a trauma-informed approach amongst midwives and maternity care providers in the postnatal period may help to detect emerging or established persisting trauma-related symptoms. For women with sub-clinical postpartum PTSD symptoms a detailed enquiry may be more effective in identifying postpartum PTSD at a later postnatal stage e.g., at six weeks postpartum. Maternity services should provide ongoing supports for women who have experienced birth trauma.
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