Abstract
BackgroundHigh numbers of women experience a traumatic birth, which can lead to childbirth-related post-traumatic stress disorder (CB-PTSD) onset, and negative and pervasive impacts for women, infants, and families. Policies, suitable service provision, and training are needed to identify and treat psychological morbidity following a traumatic birth experience, but currently there is little insight into whether and what is provided in different contexts. The aim of this knowledge mapping exercise was to map policy, service and training provision for women following a traumatic birth experience in different European countries.MethodsA survey was distributed as part of the COST Action “Perinatal mental health and birth-related trauma: Maximizing best practice and optimal outcomes”. Questions were designed to capture country level data; care provision (i.e., national policies or guidelines for the screening, treatment and/or prevention of a traumatic birth, service provision), and nationally mandated pre-registration and post-registration training for maternity professionals.ResultsEighteen countries participated. Only one country (the Netherlands) had national policies regarding the screening, treatment, and prevention of a traumatic birth experience/CB-PTSD. Service provision was provided formally in six countries (33%), and informally in the majority (78%). In almost all countries (89%), women could be referred to specialist perinatal or mental health services. Services tended to be provided by midwives, although some multidisciplinary practice was apparent. Seven (39%) of the countries offered ‘a few hours’ professional/pre-registration training, but none offered nationally mandated post-registration training.ConclusionsA traumatic birth experience is a key public health concern. Evidence highlights important gaps regarding formalized care provision and training for care providers.
Highlights
High numbers of women experience a traumatic birth, which can lead to childbirth-related posttraumatic stress disorder (CB-post-traumatic stress disorder (PTSD)) onset, and negative and pervasive impacts for women, infants, and families
In this study we report on a knowledge mapping exercise to help identify the policies, services, and resources currently available for women following a traumatic birth [28]
We considered such insights could help identify ‘promising’ practices, or key service and policy gaps
Summary
High numbers of women experience a traumatic birth, which can lead to childbirth-related posttraumatic stress disorder (CB-PTSD) onset, and negative and pervasive impacts for women, infants, and families. Suitable service provision, and training are needed to identify and treat psychological morbidity following a traumatic birth experience, but currently there is little insight into whether and what is provided in different contexts. Women who experience a traumatic birth report a range of psychological, social, cognitive, and behavioural related impacts. These include low self-esteem, relationships difficulties with their partner and infant, social isolation, negative self-perceptions, early and unintended breastfeeding cessation, and difficulties with help seeking [10]. A recent systematic review and meta-analysis identified ~ 4% of women in general community samples, and ~ 19% of women in high-risk samples (i.e., previous history of mental illness, PTSD, premature birth, neonatal loss) go on to develop childbirth-related PTSD (CB-PTSD) [12]
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