Traumatic Birth Experiences Research Articles

Posttraumatic Stress Symptoms Among Obstetricians with Personal Experience of Birth Trauma.

Psychological birth trauma (BT), defined as an event that occurs during labor and delivery involving actual or threatened harm or death to the pregnant person and/or their baby, has been reported in up to one-third of births. Obstetrician-Gynecologists (OBGYNs) who personally experience BT are at a unique risk of re-traumatization upon return to work. We aimed to investigate the prevalence of personal BT among obstetricians and their perceptions of how personal BT impacts their experience of caring for obstetric patients. We performed a web-based survey of OBGYNs who had given birth. Participants were recruited from the "OMG (OBGYN Mom Group)" on Facebook. The questionnaire assessed individual's personal experience of childbirth using items adapted from the "City Birth Trauma Scale" to assess post-traumatic symptoms related to their childbirth and patient interactions following personal experience of BT. Responses were categorized by whether or not the participant considered one or more of their own births to be traumatic. Post-traumatic stress symptoms (PTSS) and symptoms of occupational re-traumatization were compared by reported BT. Bivariable analyses were used. Of the 591 OBGYNs who completed the survey, 180 (30.5%) reported experiencing BT. Ninety-two percent of OBGYNs cared for birthing patients after giving birth. There were no differences in demographic or clinical practice characteristics between those with and without BT. OBGYNs with BT experienced PTSS including flashbacks (60.6% vs 14.4%), amnesia (36.7% vs 20.9%), and insomnia (24.4% vs 1.2%) at higher rates than those without BT (p<0.001). Almost 1/3 of OBGYNs in this sample reported personally experiencing BT, mirroring data from reported BT rates in the general population. Given OBGYNs are at a high risk for occupational re-traumatization, initiatives focused on improving support for birthing OBGYNs upon returning to work should be studied to assess impact on emotional wellness among practicing OBGYNs.

Do adverse childhood experiences increase the risk of postpartum traumatic stress and depression?

This study was conducted to determine the effect of childhood adverse experiences on the risk of postpartum posttraumatic stress disorder (PP-PTSD) and postpartum depression (PPD). This descriptive study was conducted with 417 mothers between 1 March and 30 April 2022. Data were collected using a demographic and obstetric information form, the Adverse Childhood Experiences Questionnaire (ACE), City Birth Trauma Scale (CityBiTS) and Edinburgh Postpartum Depression Scale (EPDS) through the Google Forms platform. The mothers participating in the study had a mean age of 30.47 ± 4.21 years, 65.9% (n = 275) had at least one ACE, 10.3% (n = 43) met all of the DSM-5 PTSD criteria according to the CityBiTS, and 91.8% (n = 383) had at least one traumatic stress symptom. Correlation analysis revealed weak positive associations between number of ACEs and CityBiTS score (p < 0.001, r = 0.328) and EPDS score (p < 0.001, r = 0.291) and a moderate positive association between CityBiTS and EPDS scores (p < 0.001, r = 0.601). PP-PTSD was found to be a partial mediator variable between ACE and PPD. The presence of ACE in mothers was found to increase the risk of developing PPD, both alone and when combined with traumatic birth experience. Therefore, we believe that screening for a history of ACE during pregnancy, investigating traumatic birth experiences in the postpartum period, closer follow-up of mothers with both ACE and traumatic birth experiences and increasing support systems will be beneficial in the prevention and early diagnosis of PPD.

"Who cares about us?" Results of a cross-sectional study on the psychosocial health of obstetricians and midwives after traumatic birth experiences

Traumatic births not only cause emotional stress for expectant parents but can also affect the psychosocial health of midwives and obstetricians due to their professional demands. To evaluate the impact of traumatic birth experiences on the psychosocial health of obstetric healthcare professionals. A cross-sectional study using validated measurement tools (Impact of Event Scale Revised IES-R, Copenhagen Burnout Inventory CBI) and assessing post-traumatic growth (PGI-SF) through an online survey of midwives and obstetricians in German-speaking areas. The study included 700 participants with peripartum and/or personal traumas. Of the 528 participants who completed the IES-R, 33 (6.3%) with post-traumatic stress disorder (PTSD) received less support from colleagues (p = 0.007) and were more likely to experience workplace consequences (p < 0.001) than participants without PTSD. A moderate to high level of burnout was found in 66.2% of the 542 participants who completed the CBI. Personal growth through experiencing trauma was reported by 75.9% of the 528 participants who completed the PGI-SF. The psychosocial health of midwives and obstetricians is at risk due to traumatic birth experiences. Screening tests and the provision of collegial and professional debriefings to strengthen resilience are essential preventive interventions.

Mother-infant attachment from the perspective of young mothers: Does the data support a maternal instinct?

Some conceptualizations of attachment imply an instinctual behavior that occurs naturally. Mothers who endorse this view are at greater risk for psychological stress, depression, and harsh parenting styles if they do not feel an immediate bond with their infant postpartum. The purpose of this study is to explore actual experiences of attachment from the perspective of young mothers (N = 75, Mage = 19.45 years) and based on these findings the extent to which there is empirical support for a maternal instinct. Mothers were interviewed at home three times (2 weeks, four months, and seven months postpartum), and interviews were thematically analyzed using an open coding method. Three broad themes and six sub-themes emerged: 1) experiences with the immediacy of attachment at birth are diverse (traumatic birth experience, sense of a maternal identity), 2) contextual factors on the bonding experience (physical touch-based caretaking, parenting stress and depression), and 3) time spent parenting influences attachment (reciprocity, parental confidence/knowledge). In conclusion, we could not find empirical evidence to support an innate maternal instinct. Despite diverse experiences with felt attachment at birth, all mothers perceived that the mother-infant connection was influenced by contextual factors after birth and was strengthened over time with more care-taking experience. This suggests that mothers likely developed a “maternal instinct” through repetitive interaction with their infant as the primary caretaker rather than a genetic predisposition to be superior nurturing parents.

Narrative Exposure Therapy for a Traumatic Birth Experience With the Non-Birthing Parent: A Single Case Study

Traumatic birth experiences are common and can be extremely damaging to an individual’s health and well-being. Perinatal posttraumatic stress disorder (PTSD) is a common complication following a traumatic birth experience. While emerging literature has focused on interventions to reduce maternal PTSD, there is virtually no clinical information on interventions targeting perinatal PTSD for the nonbirthing person following a traumatic birth experience. This case series is presented to demonstrate how Narrative Exposure Therapy (NET) can be used to address the unique needs of a non-birthing person following a traumatic birth experience.A patient sought treatment following witnessing his wife’s unexpected traumatic birth experience and subsequent placement of his daughter in the neonatal intensive care unit. Treatment was conducted at a specialty PTSD clinic through an urban academic medical center in the Midwestern United States. An advanced clinical psychology student conducted 10 sessions of NET under the supervision of a licensed clinical psychologist. NET treatment included psychoeducation, laying the lifeline (i.e., outlining significant events related to the birth experience), 6 imaginal exposures, a final reading of exposure transcripts, and a termination session. Patient-reported outcome measures were collected at baseline, week 8, and following treatment termination. The patient demonstrated a substantial reduction in PTSD, depressive, and dissociation symptoms and reported subjective improvement with NET. At termination, the patient no longer met criteria for PTSD. This case study provides guidance for a valuable treatment option for a nonbirthing partner’s PTSD following childbirth and highlights future directions for parental PTSD treatment.

The Impact of Prenatal or Perinatal Education by Primary Healthcare Providers on Traumatic Birth Experiences

The Impact of Prenatal or Perinatal Education by Primary Healthcare Providers on Traumatic Birth Experiences

Perinatal posttraumatic stress disorder as a predictor of mother-child bonding quality 8 months after childbirth: a longitudinal study

BackgroundNegative childbirth experiences can be related to the onset of perinatal post-traumatic stress symptomatology (P-PTSS), which significantly impacts the mother and the infant. As a response in the face of the discomfort caused by P-PTSS, maladaptive emotion regulation strategies such as brooding can emerge, contributing to the consolidation of post-partum depressive symptoms. Ultimately, both types of symptomatology, P-PTSS and post-partum depression, can act as risk factors for developing mother-child bonding difficulties. Still, this full set of temporal paths has to date remained untested. The present longitudinal study aimed to analyze the risk factors associated with the appearance of P-PTSS after post-partum and to test a path model considering the role of P-PTSS as an indirect predictor of bonding difficulties at eight months of postpartum.MethodsAn initial sample of pregnant women in the third trimester of gestation (N = 594) participated in a longitudinal study comprising two follow-ups at two and eight months of postpartum. The mothers completed online evaluations that included socio-demographic data and measures of psychological variables. A two-step linear regression model was performed to assess the predictive role of the variables proposed as risk factors for P-PTSS, and a path model was formulated to test the pathways of influence of P-PTSS on bonding difficulties.ResultsA history of psychopathology of the mother, the presence of depression during pregnancy, the presence of medical complications in the mother, and the occurrence of traumatic birth experiences all acted as significant predictors of P-PTSS, explaining 29.5% of its variance. Furthermore, the path model tested further confirmed an indirect effect of P-PTSS, triggered by a negative childbirth experience, on subsequent bonding difficulties eight months after labor through its association with higher levels of brooding and, ultimately, postpartum depression levels. A further path showed that bonding difficulties at two months postpartum can persist at eight months postpartum due to the onset of brooding and postpartum depression symptoms.ConclusionWe identified a set of robust predictors of P-PTSS: the mother’s previous history of depression, perinatal depression during pregnancy, the presence of medical complications in the mother and the occurrence of traumatic birth experiences, which has important implications for prevention. This is particularly relevant, as P-PTSS, when triggered by a negative childbirth experience, further indirectly predicted the development of mother-child bonding difficulties through the mediation of higher use of brooding and symptoms of postpartum depression. These findings can serve as a basis for developing new longitudinal studies to further advance the understanding of perinatal mechanisms of mental health.

‘Would I risk it again?’ The long-term impacts of a traumatic birth, as experienced by fathers

ABSTRACT Background Extensive research has explored the impact of traumatic births on mothers, capturing enduring adverse outcomes as well as post-traumatic growth. The literature on fathers‘ experiences of birth trauma is more limited and little is known of the ongoing impact. The present study aimed to investigate the long-term effects of attending a traumatic birth. Method Semi-structured interviews were completed with fathers who identified as having a traumatic birth experience two or more years ago. Thematic analysis was conducted on eight interview transcripts. Results Despite the time since the birth trauma, fathers described ongoing impact, which is captured in five themes. Four of these focus on the negative impacts: their attempts to cope by boxing away emotions, which they thought they should not feel; anxieties over having further children; negative effects on parenting; and ongoing distress or negative impact on their wellbeing. The final theme highlighted some positives from the experience, primarily a strengthened relationship with their partner. Conclusions Traumatic birth can result in fathers experiencing difficulties beyond the perinatal period, whilst thinking that they should not feel or discuss their distress. As a result of a traumatic birth fathers can experience ongoing guilt and poor mental health, which may lead them to delay subsequent pregnancies. Most participants had not accessed support regarding the traumatic birth, instead coping by trying to avoid their memories and emotional reaction. These findings highlight the need for increased acknowledgement of the impact of birth trauma and intervention for fathers, during and after the perinatal period.

To explore the impact of traumatic birth experiences on midwives' experience of empathy: A qualitative study

ObjectiveThis study aimed to investigate the experiences of Chinese midwives during traumatic birth experiences and their impact. By doing so, we hope to develop effective empathetic educational strategies and provide valuable insights to improve the midwifery support system in China. MethodsThis study adopted Colaizzi's phenomenological approach, which aimed to understand and explore human experiences from the standpoint of the participants. A purposive sampling method was used to select 16 midwives for semi-structured interviews. The Colaizzi 7-step method was used to analyze the interview data. FindingsThree themes and eight sub-themes were developed by analyzing and integrating the interview data. These included intertwined negative experiences (self-blame and guilt, regurgitated disturbances, intense and persistent physical and psychological discomfort, and low confidence in midwifery decision-making behaviours), the coexistence of positive effects (increased ability to tolerate life uncertainty, increased sense of control in coping with traumatic birth experiences), and needs and expectations (confiding in co-workers, an expectation of professional psychological support interventions). ConclusionsThe experiences of midwives in showing empathy during traumatic birth experiences are complex and multifaceted. It is crucial to recognize and address negative empathic experiences, provide coping strategies, and enhance positive empathic experiences. Midwives' grief counselling competence education should be strengthened, as should their psychological well-being and the midwifery support system.

Birth trauma in a population requiring inpatient mental health care in the postpartum period.

This study explores rates of birth-related symptoms of trauma in a population of parents experiencing severe perinatal mental illness. Birthing-parents admitted to a perinatal inpatient unit completed birth trauma measures on admission which were descriptively analyzed. The population had higher rates of birth-related potentially traumatic events and trauma-related symptoms than the general population. The findings highlight that assessing for and responding to experiences of birth trauma is highly relevant to an inpatient perinatal population.

Primary Birth Trauma in Australian Midwives: A Correlational Study

BACKGROUND:The Australian Health Practitioners Registration Agency (AHPRA) records 98.7% of the 32,000 registered midwives as female. In 2021, Australia recorded 309,996 births, and one in three women experienced birth trauma. While the exact proportion of midwives who have given birth is unknown, it is likely the majority. As a consequence, 5,000–11,000 midwives may have experienced primary birth trauma (PBT). Little is known about midwives’ personal experience of birth trauma and its relationship to factors that affect their experience of the maternity workplace setting.AIMS:This study aimed to explore mental health morbidity and factors associated with the severity of PBT in Australian midwives and the relationships between these factors and professional quality of life.METHODS:Australian registered midwives 12 months post birth trauma experience and having returned to the maternity workplace without restrictions to their AHPRA registration were included. Data were collected via an online survey with four validated tools and general demographic information.FINDINGS:Midwives who have experienced PBT have symptomology for posttraumatic stress disorder, depression, anxiety, and burnout. Midwives with these symptomologies work within maternity settings with little known about the implications of accumulative symptoms, their impact on care provision or clinical decision-making, and overall long-term personal and professional well-being and health.CONCLUSION:This study found that midwives experience psychological, professional, and personal issues and trauma symptomology associated with their own primary birth trauma. Further research exploring simplified symptomatology identification and appropriate interventions both inside and outside the work environment is required to improve midwives’ mental health, rates of retention in the workplace, and job satisfaction.

Caesarean delivery on maternal request: the perspective of the postpartum women

BackgroundCaesarean delivery on maternal request (CDMR) is an increasing delivery option among women. As such, we aimed to understand the reasons that led pregnant women to request a caesarean delivery.MethodsA phenomenological study was conducted with semi-structured interviews, in a convenience sample, for women who had undergone a CDMR between March and June 2023, in a public reference university hospital in Campinas, Brazil. The interviews were recorded, transcribed and subjected to thematic analysis, supported by Nvivo®, and Reshape®.ResultsWe interviewed eighteen women between 21 and 43 years of age. The reasons for C-section as their choice were: 1) fear of labour pain, 2) fear for safety due to maternal or fetal risks, 3) traumatic previous birth experiences of the patient, family or friends 4) sense of control, and 5) lack of knowledge about the risks and benefits of C-section.ConclusionsThe perception of C-section as the painless and safest way to give birth, the movement of giving voice and respecting the autonomy of pregnant women, as well as the national regulation, contribute to the increased rates of surgical abdominal delivery under request. Cultural change concerning childbirth and better counseling could support a more adequate informed decision-making about delivery mode.

Birth, trauma, and communicating maternal health

This paper focuses on birth choices, experiences, and perceptions of traumatic or challenging birth experiences. Maternal and postpartum health is a topic of importance in the United States, given increasing maternal mortality rates , recognition of factors involved in postpartum depression and anxiety, and increasing rates of inductions and cesarean births (c-sections) despite the risks that come with them (Betran et al., 2018; Sandall et al., 2018). The overarching research questions for this project are: How do women define and perceive their negative birth experiences? What are the consequences of the experiences on future communication and care decisions? Using in-depth, semi-structured interviews of women who personally define their birth experience as difficult or traumatic, this paper discusses the potential consequences of listening, language, and support.

An Undervalued Diagnosis: Post-Traumatic Stress Disorder in the Perinatal Period: A Case Report

BACKGROUND: Perinatal Post-Traumatic Stress Disorder (PTSD) is a disorder that occurs around childbirth, typically after a traumatic birth experience, where women may feel violated due to traumatic childbirth interventions they cannot control. Traumatic birth is defined as an event in which the mother perceives a real or perceived threat to herself or her baby, causing intense fear, helplessness, and horror. This can be considered an obstetric sequel. It is relevant to note that among pregnant women, perinatal PTSD is the third most common psychiatric disorder, with a prevalence ranging from 0.8% to 43% worldwide. Despite its significance, it is little-known, underdiagnosed, and often confused with other conditions such as depression or anxiety. Furthermore, it results in serious family, social, and occupational dysfunctions and is associated with other pathologies. Clinically, women with perinatal PTSD experience symptoms such as re-experiencing the event, detachment from the newborn, nightmares, irritability, and rejection of motherhood. This can lead to consequences for the mother, ranging from a desire not to become pregnant again to severe symptoms such as dissociation, stress, anxiety, and depression. It also affects those close to the mother, such as the partner and family. The aim of this work is to describe perinatal PTSD and emphasize the importance of early identification and appropriate treatment by medical professionals for the benefit of mothers and their children THE CASE: We describe a 35-year-old patient with a history of mixed depressive and anxiety disorder since 2018 experiences perinatal post-traumatic stress disorder. This is related to physical and verbal abuse during her second childbirth, resulting in a traumatic experience. Her childhood was marked by the feeling that her mother favored her younger sister and subjected her to physical and emotional abuse. The first pregnancy was unplanned, and she faced humiliation and abandonment by her partner. Despite the circumstances, the birth was a positive experience. The second pregnancy was planned and desired, but during childbirth in a different clinic from the first, she experienced inadequate care conditions, a lack of privacy, and physical abuse by medical staff. She also received inappropriate comments from the attending gynecologist. During the postpartum period, she shared a room with a cancer patient, complicating her experience. After childbirth, she experienced a hypertensive disorder in the postpartum and chose not to return to the hospital where she gave birth due to her traumatic experiences. Overall, her story reveals a series of challenging experiences related to motherhood that have contributed to her current mental health state. CONCLUSION: Perinatal PTSD is a psychiatric disorder that affects a significant number of pregnant and postpartum women. Its prevalence varies widely, reflecting the need for increased awareness and early detection. Despite its considerable impact on maternal mental health and well-being, perinatal PTSD is often overlooked or confused with other conditions such as depression and anxiety. It's important to raise awareness among medical staff about this disorder and provide a comprehensive and empathetic approach to enhance care for mothers during childbirth and the postpartum period.

Prospective assessment of mental and physical health of maternal near-miss women: A low-middle-income country's experience.

Traumatic birth experience is an unaddressed arena, especially in Asian women, with several societal stigmas lingering around. A study was undertaken to simultaneously assess the post-partum mental and physical health follow-up of maternal near-miss (MNM) women and compare it with women of uneventful deliveries. The prospective cohort study enrolled 88 MNM women (case cohort) and 80 women with an uneventful peri-partum period (control cohort) at the same time. The participants were followed up with Edinburgh Postnatal Depression Scale (EDPS), PTSD Checklist - Civilian Version (PLC-C), and a 36-item short-form-survey form over 6 months after the delivery. The case group had higher mean EPDS and PLC-C scores, with poor quality of life (QOL) performance, compared to the control group at 6 weeks and 3 months, and 6 months follow-up (P < 0.05). At the sixth-week follow-up visit, the study observed that 28 (31.8%) women from the case group required a psychiatry consultation compared to the control group with only two (2.5%) participants (P < 0.001). At 3 months, an evident difference was noted on various QOL parameters, such as limitations due to physical health and emotional problems, energy fatigue, general health, and health change parameters between the two groups (P < 0.05). The difference persisted at 6-month follow-up as well for limitations due to physical health, energy fatigue, and general health parameters only (P < 0.05). There is an urgent need for a multi-departmental collaborative approach at the hospital level and policy-making decisions at higher levels for the mental health of Asian women facing MNM events.

Informing about childbirth without increasing anxiety: a qualitative study of first-time pregnant women and partners’ perceptions and needs

BackgroundComplications requiring medical interventions during childbirth are far from rare, even after uncomplicated pregnancies. It is often a challenge for maternity healthcare professionals to know how to prepare future parents for these eventualities without causing unnecessary anxiety. Studies on traumatic birth experiences have shown that feelings of loss of control, insufficient information, and lack of participation in medical decisions during childbirth are factors of difficult experiences. However, little is known about the information and communication needs of expectant parents about childbirth during the prenatal period. To gain a deeper understanding of the information and communication needs of first-time pregnant women and partners, we explored their perceptions and expectations for their upcoming childbirth, and the actions they initiated to prepare for it.MethodsSemi-structured interviews were conducted individually with first-time pregnant women and partners of pregnant women aged 18 years or older, with an uncomplicated pregnancy. Thematic analysis was used to identify themes and sub-themes.ResultsTwenty expectant parents (15 pregnant women and five partners of pregnant women) were interviewed. Six themes were identified: Childbirth event; Childbirth experience; Childbirth environment; Organisation of care; Participation in decision making; Roles within the couple and transition to parenthood.ConclusionsThis study contributes to a better understanding of the information needs of future parents expecting their first child. Results highlighted that the notion of “childbirth risks” went beyond the prospect of complications during birth, but also encompassed concerns related to a feeling of loss of control over the event. Expectant parents showed an ambivalent attitude towards consulting risk information, believing it important to prepare for the unpredictability of childbirth, while avoiding information they considered too worrying. They expressed a desire to receive concrete, practical information, and needed to familiarise themselves in advance with the birth environment. Establishing a respectful relationship with the healthcare teams was also considered important. The findings suggest that information on childbirth should not be limited to the transmission of knowledge, but should primarily be based on the establishment of a relationship of trust with healthcare professionals, taking into account each person’s individual values and expectations.

Impact of trauma, support, and control perceptions during childbirth on post-traumatic stress disorder among Syrian immigrant adolescent pregnant women

ObjectiveThe probability of experiencing mental health problems in the perinatal period is high for adolescent women. Immigration is a complicated phenomenon that increases the risk of encountering temporary or permanent psychological problems. This study aims to determine Syrian immigrant adolescent women's support and control perception levels during childbirth, birth trauma levels, and posttraumatic stress disorder incidence and affecting factors. MethodsThis study used a prospective cohort design and was conducted in a hospital in Adana, a city in southern Turkey, between February and April 2022. It included 122 Syrian adolescent immigrant women, and data were collected in two interviews. While the first interview was conducted within the first 24 hours following birth, the second interview was conducted one month after birth. Data were collected through structured interviews using standardized questionnaires, including the Personal Information Form, the City Birth Trauma Scale, the Support and Control in Birth Scale, and the Post-traumatic Stress Disorder Checklist for DSM-5. FindingsThe average age of participating women was 17.40±0.94. The participants’ Perceived Support and Control in Birth Scale total score was 100.55±20.12, the City Birth Trauma Scale total score was 43.11±13.29, and the Post-traumatic Stress Disorder Checklist total score was 30.36±16.86. Of all the participating women, 26% were found to have post-traumatic stress disorder symptoms in the postpartum period. A relationship was found between support and control perceptions during childbirth and post-traumatic stress disorder symptoms. ConclusionThis study found that immigrant adolescent women's support and control perceptions during childbirth were better than expected, and they had a high level of perceived trauma during childbirth. The presence of birth trauma emerged as a robust predictive factor for posttraumatic stress disorder, underscoring its critical role in maternal mental health. A positive childbirth experience, which is important for all women, has become an increasing need for immigrant women. There is a need for developing and sustaining health policies guaranteeing culturally sensitive care to prevent immigrant women from having a traumatic birth experience.

The intersection of traumatic childbirth and obstetric racism: A qualitative study.

Traumatic childbirth experiences are common in the United States - affecting a third to a fourth of mothers - with significant negative impacts on maternal health. Yet most research on traumatic childbirth focuses on white mothers' experiences. Drawing on a racially and ethnically diverse sample of mothers who experienced traumatic childbirth, this exploratory qualitative study examined Black, Latina, and Asian mothers' traumatic birth experiences and the role of obstetric racism in shaping these experiences. In-depth, semi-structured interviews were conducted in 2019-2020 with 30 mothers who identified as women of color (37% Black, 40% Latina, and 23% Asian) who gave birth in the US and self-identified as having experienced a traumatic childbirth. Data were analyzed using qualitative content analysis. Mothers reported obstetric racism as core to their traumatic birth experiences. This racism manifested through practitioners' use of gendered and racialized stereotypes, denying and delegitimizing mothers' needs. Mothers shared key consequences of the obstetric racism they experienced, including postpartum anxiety and depression, increased medical mistrust, and decreased desire for future children. Mothers' reports suggest that obstetric racism played a role in their traumatic birth experiences. Particularly, practitioners' deployment of gendered and racialized stereotypes influenced mothers' treatment during birth. These findings point to opportunities to address obstetric racism during childbirth and improve patients' experiences through enhancing their agency and empowerment. The findings, in addition, highlight the need for increased practitioner training in anti-racist practice and cultural humility.

Birth trauma: the elephant in the nursery

ABSTRACT Method The current study used a multiperspectival (dyadic) IPA approach to interview eight participants (N = 4 heterosexual couples) where one parent was help-seeking for the experience of birth trauma. Results Analysis resulted in four superordinate themes: (1) From perfect plan to shattered reality, (2) Trauma in the healthcare system, (3) Trauma in the family system and (4) The post-trauma family: Navigating the new normal. Discussion Parents described a shared experience of birth trauma during birth. However, fathers’ perceived trauma ended in the delivery room whilst mothers’ continued far beyond this. The dyadic focus showed a divergence of experience postnatally: differing levels of awareness to distress existed between partners, mothers experienced bonding difficulties and parents took to separate coping mechanisms. The trauma remained invisible and unspoken as couples avoided discussions about the birth, coped silently and separately. The parents identity changed following the trauma as individuals, couples and as a family. Conclusion The time following a traumatic birth is experienced differently by mothers and fathers. Parents seldom discuss the trauma, hold differing perceptions of roles and needs, and struggle to support each postnatally. Clinical implications and recommendations are discussed.

Traumatic childbirth experiences, effects and coping: A qualitative study

ObjectiveChildbirth experience and perception of birth are personal. It is important to understand how the traumatic childbirth experiences affected women and for the nursing care that would be given to them. The aim of the research was to determine the childbirth experiences perceived by women as traumatic, how they were affected by these experiences, and how they coped. MethodsThe study was a descriptive phenomenological approach study. The data were obtained through semi-structured, in-depth individual interviews. Content analysis was used in the analysis of the data. The mothers were contacted by using the social media platforms. Sixteen women were included in the research who expressed that they had traumatic childbirth experiences. ResultsIt was determined that women experienced severe fear and pain during childbirth, that they were in unsuitable maternity hospital environments, and that care was not taken for their privacy. At the same time, it was determined that they experienced disorders in the postpartum period connected to their traumatic birth experiences, that they postponed their pregnancy plans due to their fear of childbirth that developed connected to traumatic childbirth or that they did not want to become pregnant, and that they did not receive sufficient support from health personnel. ConclusionIt is necessary to provide privacy during childbirth, to take into consideration the decisions of women, and to provide for their continuous support by midwives.