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.