References
The psychological impact of birth trauma on fathers: a narrative review

Abstract
Background/Aims
There is a paucity of evidence on how birth trauma can affect the mental health of fathers. This review aimed to determine the common psychological effects of witnessing traumatic events during birth for fathers.
Methods
A narrative literature review of primary research and literature reviews was conducted using the British Nursing Index, CINAHL, Maternity and Infant Care, PubMed and EBSCO. A total of 6 research articles were included.
Results
Data analysis generated three themes: toxic masculinity: the role of fathers in the birthing environment; unpreparedness: expectation vs reality; and relationships with partner and others.
Conclusions
Traumatic events during labour and birth can have a profound impact on both mother and father. Fathers may experience poor mental health in the perinatal period, which can impact their relationship with their partner and the baby. It was noted that some healthcare professionals were more supportive than others. Effective communication is essential to quality care provision, which should help to manage poor paternal mental health in the perinatal period.
Implications for practice
Services are needed to identify and address poor mental health in the perinatal period for both mothers and fathers. Antenatal education should include information about all potential outcomes during labour and birth. More healthcare professionals are needed with expertise in mental health, including the ability to assess and refer to specialist services where necessary.
Over 600 000 births were recorded in England and Wales in 2022 (Office for National Statistics, 2023), and similar rates were recorded in 2021 (Office for National Statistics, 2022), with 47% of these involving either instrumental or caesarean interventions. This creates the potential for complications during the childbirth continuum, including postpartum haemorrhage and perineal lacerations (NHS, 2022). These complications may be perceived by some women as traumatic, although this might not be representative of all women who experience obstetric complications (Greenfield et al, 2016; Attard et al, 2022). Greenfield (2021) suggested that birth trauma is characterised by lasting, physical and/or psychological damage experienced during the intrapartum period. This can result in individuals experiencing symptoms of post-traumatic stress disorder, which can last for years (Greenfield et al, 2016). Trauma may be a subjective notion and is individualised (Boals, 2018). Traumatic childbirth can be related to a variety of psychological effects, including depression, anxiety, post-traumatic stress symptoms (Seefeld et al, 2023) and, in extreme cases, postpartum psychosis (Reilly et al, 2023).
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