Abstract
BackgroundPsychological birth trauma (PBT), mainly due to overlooking maternal mental health, is a common and high prevalence public health problem in low-resource settings. Preventing PBT is a good indicator of the realization of human rights in healthcare. This work reports the results of a qualitative study that aimed to identify perceived strategies of PBT prevention among childbearing women in Iran.MethodsWe conducted semi-structured in-depth interviews with 22 mothers with history of traumatic childbirth, two mothers with positive childbirth experience, two spouses, and eight health professionals between April and June 2017. We used purposive sampling method to recruit traumatized mothers, while health experts were selected based on their relevant expertise and experience. Our initial literature review identified eight categories, using which we developed our interview guide and conducted the content analysis approach.ResultsWith the maximum possible purification, we reached 50 thematic codes. The strategies to prevent PBT are generally summarized in four major themes and 13 categories: 1) skill-builder knowledge [Birth preparedness, Mothers’ empowerment in maintaining mental health, Understanding the importance of mental care in maternity services], 2) responsible caregiving [Support loop, Good behavior of the caregivers, Deepening trust, Struggle with medicalization of childbirth, Labour pain relief, Special services for maternal mental health], 3) the alliance of prenatal and antenatal care [Continuity of care, Coordination of prenatal and antenatal caregivers], and 4) reconstruction of the structures [Efficient management, Rebuilding physical structures].ConclusionsThis is a comprehensive approach towards PBT prevention, which can guide future efforts to reduce PBT at the clinical level and open further avenues for future studies. We recommend policy makers to consider the integration of multilevel and multidimensional PBT prevention interventions, simultaneously within maternity care services packages for promotion of mental health.
Highlights
Psychological birth trauma (PBT), mainly due to overlooking maternal mental health, is a common and high prevalence public health problem in low-resource settings
Despite some evidence-based strategies and potential approaches to prevent PBT, the research is lacking in this area and an information gap exists about the listed strategies that can cover all aspects of maternity care and result in clinical success [9]
This qualitative study added a lot of details to the pre-defined categories; which are indicated with an asterisk (*) in the text and Table 4
Summary
Psychological birth trauma (PBT), mainly due to overlooking maternal mental health, is a common and high prevalence public health problem in low-resource settings. This work reports the results of a qualitative study that aimed to identify perceived strategies of PBT prevention among childbearing women in Iran. Trauma exposure and negative experience of birth care is associated with post-traumatic stress disorder (PTSD) following PBT [2]. A United States-based study reported the incidence of PBT as 34%; 34.3% of those experiencing trauma, had some PTSD symptoms and 5.7% were fully symptomatic [3]. Despite some evidence-based strategies and potential approaches to prevent PBT, the research is lacking in this area and an information gap exists about the listed strategies that can cover all aspects of maternity care and result in clinical success [9]. A comprehensive approach is necessary for successful prevention of mental illnesses; which requires interdisciplinary efforts through multilevel and multidimensional strategies [7]
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