Birth experiences and birth trauma: an exploration of psychosocial and contextual factors

Literature Review

Childbirth Related Post Traumatic Stress Disorder (CB-PTSD) is a mental health disorder which occurs for some people following a traumatic experience of childbirth. This review investigated to what extent ‘psychosocial’ (defined as interpersonal) factors occurring during childbirth contribute to the development of CB-PTSD. 41 studies were included. It was found that negative experiences of care/support from professionals and birth partners contribute significantly to the development of CB- PTSD, whereas positive experiences can be protective. This suggests that the interpersonal aspects of care/support should be considered in the development of prevention strategies. Evidence for the importance of professional care/support was stronger than for birth partners. Further research is needed which looks at the relative importance of different aspects of care/support, and how different types of factors interact to cause CB-PTSD.

Empirical Study

There were many changes to ordinary practices in maternity services in the United Kingdom (UK) during the COVID-19 pandemic. However, research into the impact of these changes on birthing people remains limited. This study sought to address this by investigating the experiences of women who gave birth during the first ‘national lockdown’, from a psychological and trauma-informed perspective. The responses of 69 women to a survey were included in a Framework Analysis. Findings included themes of ‘isolation and aloneness’, ‘practical adversities’ ‘uncertainty’, ‘relational (un)safety’, and ‘lasting impact’. Experiences of isolation and aloneness were particularly dominant, usually in relation to restrictions placed on partner attendance at the birth. Many women reported lasting negative psychological impacts from this, which should be considered carefully in future pandemic or disaster response planning. More positively, this study also found evidence to suggest that relationally attuned care can help to protect positive birth experiences for women, even in the relatively extreme circumstances of a pandemic.