Promoting a Positive Birth Experience for Women Who Have a History of Trauma

Abstract

Survivor Services is a birth-planning program for women who have a history of trauma, with the goal of collaborating to create a positive birth experience. Women with a history of trauma are at higher risk for having a traumatic birth experience. Possible sequelae of patient-perceived traumatic birth may include posttraumatic stress disorder or symptoms, postpartum mood disorders, negative effects on family relationships, impaired bonding that can increase risk for child abuse and neglect, and avoidance of seeking future medical care for oneself and/or family. For these reasons, the birth experience should be considered a community health issue that is deserving of resources. This birth-planning service seeks to create connections among the patient-centered care team to ensure the patient feels in control, cared for, and listened to, with the goal of avoiding a traumatic birth experience in this high-risk population. The prenatal consultation with a trauma-informed-care–trained obstetric nurse results in a written birth plan approved by the patient and shared with the health care team. The potential impact of past trauma on the birth experience will be reviewed, in addition to the potential sequelae of a traumatic birth experience. The format of the birth-planning consultation will be reviewed, including a unit tour and acclimation to the birthing space, patient-led interview, and review of triggers and coping strategies. Tools and strategies will be provided to replicate this birth-planning service. Qualitative data supporting the positive effect of the birth-planning service on the patient’s perception of their birth experience will be reviewed. An institutional review board–approved, postpartum survey is sent to all consenting program participants. All respondents have reported “positive” or “somewhat positive” overall birth experiences. To date, no respondents have reported a negative birth experience. Collaborative birth planning can have a positive effect on a patient’s perception of their birth experience in women who are at high risk for a traumatic or negative birth. The program format will be shared and strategies for replicating the program will be presented.