Maternal mental health and birth trauma - Women´s perceptions of birth trauma and adequacy of healthcare practices in labour-ward care: A narrative review

Abstract

Background: It is thought that up to 45% of women globally report being mistreated by healthcare providers during childbirth. Research further suggests that an estimated 3-4% will go on to experience postpartum post-traumatic stress disorder. The negative effects of poor maternal mental health are many, for both mother and child. While there is an adequate amount of research on birth trauma, women’s own perceptions of their traumatic birth experience are missing. There is therefore a need to better understand how women, as told by themselves, perceive healthcare practices, specifically the actions of healthcare providers, in relation to birth trauma. Not only would this promote more positive and fulfilling labour-ward experiences, but also better mental and physical health outcomes, making it a clinically significant area worth looking more at. Aims: The aims of this study are to explore and synthesize existing raw qualitative data on women’s (1) experiences of a traumatic birth and (2) perceptions of the adequacy of healthcare practices in addressing their needs. Method: A narrative review was undertaken on two databases, PubMed and PsycInfo. 31 peer-reviewed qualitative studies met the eligibility criteria and were included in the review. The raw data from these were then analyzed using Braun & Clarke’s thematic analysis. Results: Three higher-level main themes were identified: (1) Over-medicalized, (2) Made to be a passive participant, and (3) Undermining the dignity of one’s experience. These were then further organized into seven subthemes. Conclusion: During pregnancy, childbirth, and postpartum, women are especially vulnerable and need to have healthcare providers that will both guide and support them. For the provision of truly woman-centered care, a means to protect against birth trauma, dedicated space has to be given to hear from women about how they themselves want to be cared for. Mothers deserve much more than the mistreatment and abuse many are currently faced with, and it is our responsibility as public health professionals to advocate for meaningful change.