Vicarious birth trauma and post-traumatic stress disorder: Preparing and protecting student midwives
Post-traumatic stress disorder was first recognised in war veterans who had experienced extreme violence during military combat; however, it is now understood to be caused by a wide range of traumatic experiences, including serious accidents, abuse, natural disasters or terrorist attacks—any event in which a person fears for their life. Traumatic childbirth is also a potential cause, not only for the mother, but also for those who may witness the birth, such as midwives, student midwives, obstetricians and birth partners. This condition is termed vicarious birth trauma.
This article will examine the definition of both vicarious birth trauma and post-traumatic stress disorder, and consider the evidence in relation to how these conditions affect midwives and student midwives. It will offer suggestions for personal and organisational management and support strategies, based on research findings and expert advice.
The focus of the theoretical aspect of the first year of the pre-registration midwifery programme is on low risk and physiological birth; however, the clinical area is dynamic and unpredictable in nature, and so, in reality, student midwives may be witness to traumatic events from day 1 of their clinical practice. Given that anyone who witnesses a traumatic birth can also experience symptoms of vicarious birth trauma or post-traumatic stress disorder (PTSD), it is important to consider what measures are put in place before, during, and after clinical placements to prepare and support students to cope with the emotional stressors of the job. This is particularly necessary when one considers the severity of the condition and its impact on the individual. As Griffin and Tyrell (2013:319) describe:
‘A traumatised creature lives in a private hell, terrorised by an invisible mental wound, helplessly in thrall to a powerful emotional memory of a life-threatening event’.
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