In order to improve care, it is important to understand what interactions and actions are associated with trauma. Health care professionals have an ethical, legal and professional obligation to provide safe and respectful care. A study by Harris and Ayers also found that the strongest predictor of developing birth related PTSD was interpersonal difficulties with care providers, in particular experiencing a lack of support.Ī recent Cochrane Review concluded that women require improved emotional support during birth from their care providers to reduce the risk trauma. Whilst not all traumatic birth experiences result in PTSD, two quantitative meta-analyses identified that negative care provider interactions are a significant risk factor for PTSD. A study by Thomson and Downe found that trauma was related to ‘fractured interpersonal relationships with caregivers’, and that women felt disconnected, helpless and isolated during birth. For example, a perceived lack of control and involvement in decision-making can contribute to the experience of trauma. Qualitative studies exploring women’s experiences of traumatic birth identify interactions with care providers as a more important factor than medical intervention or type of birth. However, Beck argues that the perception of trauma is in the ‘eye of the beholder’, and should be defined by the woman experiencing it. It has been defined as a perception of ‘actual or threatened injury or death to the mother or her baby’. Therefore, the consequences of a traumatic birth experience can be substantial and wide-ranging for women and their families.īirth trauma has been associated with medical intervention and type of birth. found that the decision to freebirth (give birth without a professional care provider) can be influenced by previous birth traumatic. For example, women may choose to birth at home to avoid repeating a traumatic hospital experience. In addition, the experience of a traumatic birth can influence a woman’s future decisions regarding where, how, and with whom she gives birth. Difficulties with early mother-baby bonding can negatively influence a child’s social, emotional and mental development. Poor mental health in the postnatal period can alter a woman’s sense of self, and disrupt family relationships. A traumatic birth experience is associated with postpartum mental health problems, including depression and post traumatic stress disorder. Care providers require training and support to minimise interpersonal birth trauma.Īround one third of women experience trauma whilst giving birth. Maternity service development and provision needs to be underpinned by a paradigm and framework that prioritises both the physical and emotional needs of women. It is necessary to address interpersonal birth trauma on both a macro and micro level. ConclusionĬare provider actions and interactions can influence women’s experience of trauma during birth. For some women these actions triggered memories of sexual assault. Women also described actions that were abusive and violent. In particular, these lies and threats related to the wellbeing of the baby. Care providers used lies and threats to coerce women into complying with procedures. Women’s own embodied knowledge about labour progress and fetal wellbeing was disregarded in favour of care provider’s clinical assessments. In some cases, women became learning resources for hospital staff to observe or practice on. This could result in unnecessary intervention as care providers attempted to alter the birth process to meet their own preferences. Women felt that care providers prioritised their own agendas over the needs of the woman. Resultsįour themes were identified in the data: ‘prioritising the care provider’s agenda’ ‘disregarding embodied knowledge’ ‘lies and threats’ and ‘violation’. Data relating to care provider actions and interactions were analysed using a six-phase inductive thematic analysis process. MethodsĪs part of a large mixed methods study, 748 women completed an online survey and answered the question ‘describe the birth trauma experience, and what you found traumatising’. It is important to understand how interpersonal factors influence women’s experience of trauma in order to inform the development of care that promotes optimal psychosocial outcomes. A traumatic birth can impact on postnatal mental health and family relationships. Many women experience psychological trauma during birth.
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