References

Ayers S. Delivery as a traumatic event: prevalence, risk factors, and treatment for postnatal posttraumatic stress disorder. Clinical Obstetrics and Gynecology. 2004; 47:(3)552-567 https://doi.org/10.1097/01.grf.0000129919.00756.9c

Ayers S, Eagle A, Waring H. The effects of childbirth-related post-traumatic stress disorder on women and their relationships: a qualitative study. Psychology, Health and Medicine. 2006; 11:(4)389-398 https://doi.org/10.1080/13548500600708409

Ayers S. Thoughts and emotions during traumatic birth: a qualitative study. Birth. 2007; 34:(3)253-263 https://doi.org/10.1111/j.1523-536X.2007.00178.x

Barriball KL, While A. Collecting data using a semi-structured interview: a discussion paper. Journal of Advanced Nursing. 1994; 19:(2)328-335 https://doi.org/10.1111/j.1365-2648.1994.tb01088.x

Bastos MH, Furuta M, Small R, McKenzie-McHarg K, Bick D. Debriefing interventions for the prevention of psychological trauma in women following childbirth. Cochrane Database of Systematic Reviews. 2015; (4) https://doi.org/10.1002/14651858.CD007194.pub2

Baxter JD, McCourt C, Jarrett PM. What is current practice in offering debriefing services to post partum women and what are the perceptions of women in accessing these services: a critical review of the literature. Midwifery. 2014; 30:(2)194-219 https://doi.org/10.1016/j.midw.2013.12.013

Baxter JD. Postnatal debriefing: women's need to talk after birth. British Journal of Midwifery. 2019; 27:(9)563-571 https://doi.org/10.12968/bjom.2019.27.9.563

Beck T, Watson S. Subsequent childbirth after a previous traumatic birth. Nursing Research. 2010; 59:(4)241-249

Beck CT, Gable RK, Sakala C, Declercq ER. Posttraumatic stress disorder in new mothers: results from a two-stage US national survey. Birth. 2011; 38:(3)216-227 https://doi.org/10.1111/j.1523-536X.2011.00475.x

Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006; 3:(2)77-101 https://doi.org/10.1191/1478088706qp063oa

Creedy DK, Shochet IM, Horsfall J. Childbirth and the development of acute trauma symptoms: incidence and contributing factors. Birth. 2000; 27:(2)104-111 https://doi.org/10.1046/j.1523-536x.2000.00104.x

Creswell J, Plano Clark V. Designing and conducting mixed methods research, 2nd edn. Thousand Oaks: Sage; 2011

Czarnocka J, Slade P. Prevalence and predictors of posttraumatic stress symptoms following childbirth. British Journal of Clinical Psychology. 2000; 39:(1)35-51 https://doi.org/10.1348/014466500163095

Elmir R, Schmied V, Wilkes L, Jackson D. Women's perceptions and experiences of a traumatic birth: a meta-ethnography. Journal of Advanced Nursing. 2010; 66:(10)2142-2153 https://doi.org/10.1111/j.1365-2648.2010.05391.x

Fenwick J, Gamble J, Creedy D, Barclay L, Buist A, Ryding E. Women's perceptions of emotional support following childbirth: a qualitative investigation. Midwifery. 2013; 29:(3)217-224 https://doi.org/10.1016/j.midw.2011.12.008

Hodnett ED. Pain and women's satisfaction with the experience of childbirth. A systematic review. American Journal of Obstetrics and Gynecology. 2002; 186:(5)S160-S172 https://doi.org/10.1016/S0002-9378(02)70189-0

Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews. 2013; (7) https://doi.org/10.1002/14651858.CD003766.pub6

Mander R. The transitional stage: pain and control. The Practising Midwife. 2002; 5:(1)10-12

McCourt C, Stevens T. Relationship and reciprocity in caseload midwifery. In: Hunter B (ed). Basingstoke: Palgrave Macmillan; 2009

McKenzie-McHarg K, Ayers S, Ford E, Horsch A, Jomeene J, Sawyer A, Stramrood C, Thomson G, Slade P. Post-traumatic stress disorder following childbirth: an update of current issues and recommendations for future research. Journal of Reproductive and Infant Psychology. 2015; 33:(3)219-237 https://doi.org/10.1080/02646838.2015.1031646

Miles MB, Huberman AM. Qualitative Data Analysis: an expanded sourcebook, 2nd edn. Thousand Oaks: Sage; 1994

Better Births: improving outcomes of maternity services in England. National Maternity Review.London: NHS England; 2016

Polit DF, Beck CT. Essentials of nursing research, 7th edn. Philadelphia: Wolters Kluwer Health/Lippincott Williams and Wilkins; 2010

Midwifery: an executive summary for the Lancet's series. 2014. https://www.thelancet.com/pb/assets/raw/Lancet/stories/series/midwifery/midwifery_exec_summ.pdf (accessed 10 December 2019)

Ritchie J. The applications of qualitative methods to social research. In: Ritchie J, Lewis J (eds). London: Sage; 2003

Sawyer A, Rabe H, Abbott J, Gyte G, Duley L, Ayers S. Parents' experiences and satisfaction with care during the birth of their very preterm baby: a qualitative study. British Journal of Obstetrics and Gynaecology. 2013; 120:(5)637-643 https://doi.org/10.1111/1471-0528.12104

Simkin P. Just another day in a woman's life? Part II: nature and consistency of women's long-term memories of their first birth experiences. Birth. 1992; 19:(2)64-81 https://doi.org/10.1111/j.1523-536X.1992.tb00382.x

Snape D, Spencer L. The foundations of qualitative research. In: Ritchie J, Lewis J (eds). London: Sage; 2003

Soet JE, Brack GA, Dilorio C. Prevalence and predictors of women's experience of psychological trauma during childbirth. Birth. 2003; 30:(1)36-46 https://doi.org/10.1046/j.1523-536X.2003.00215.x

Storksen HT, Garthus-Niegel S, Vangen S, Eberhardgran M. The impact of previous birth experiences on maternal fear of childbirth. Acta Obstetricia et Gynecologica Scandinavica. 2013; 92:(3)318-324 https://doi.org/10.1111/aogs.12072

Thomson G, Downe S. Changing the future to change the past: women's experiences of a positive birth following a traumatic birth experience. Journal of Reproductive and Infant Psychology. 2010; 28:(1)102-112 https://doi.org/10.1080/02646830903295000

Thomson G, Downe S. Emotions and support needs following a distressing birth: scoping study with pregnant multigravida women in North-West England. Midwifery. 2016; 40:32-39 https://doi.org/10.1016/j.midw.2016.06.010

Waldenstrom U, Hildingsson I, Rubertsson C, Radestad I. A negative birth experience: prevalence and risk factors in a national sample. Birth. 2004; 31:(1)17-27 https://doi.org/10.1111/j.0730-7659.2004.0270.x

Wijma K, Soderquist J, Wijma B. Posttraumatic stress disorder after childbirth: a cross sectional study. Journal of Anxiety Disorders. 1997; 11:(6)587-597 https://doi.org/10.1016/S0887-6185(97)00041-8

An exploration of reasons why some women may leave the birth experience with emotional distress

02 January 2020
Volume 28 · Issue 1

Abstract

Background

Following birth, some women report negative and traumatic feelings. There is relatively little research on women's perceptions of these emotions. It is important to understand why some women experience distress following labour. The work presented in this paper focuses on one aspect of a wider mixed methods research study.

Aims

To explore reasons why some women may leave the birth experience with emotional distress.

Method

A descriptive qualitative approach was used. A total of 16 semi-structured, qualitative interviews were undertaken. These were with women following birth, some of whom had attended a local birth reflections service. Thematic analysis was performed using typewritten transcripts.

Findings

Three key themes were identified which illuminated the topic of women's subjective distress: ‘giving birth as traumatic/horrific’, ‘lasting emotions linked to the birth process’ and ‘the impact of the health professional on women's experiences of giving birth’. As well as identifying how women are feeling following birth, this study has also highlighted how midwives can affect women's birth experience. It seems that trauma relating to the birth event may be mediated by professional behaviours and how supportive they are.

Conclusion

Lack of support by care professionals was a key factor associated with a negative birth experience. Maternity services and education providers need to ensure optimal training for all healthcare professionals who provide care to women during labour and birth.

Women use different terms to describe distress in relation to a poor childbirth experience. Whereas some women consider it as having been negative, others feel their birth was traumatic (Creedy et al, 2000; Hodnett, 2002; Soet et al, 2003; Ayers, 2004; Waldenstrom et al, 2004; Beck and Watson, 2010; Beck et al, 2011; Storksen et al, 2013). This can lead to adverse consequences, including post-traumatic stress disorder (PTSD) (Ayers, 1999; Creedy et al, 2000). Other poor consequences that have been recognised following a traumatic birth experience are poor maternal and infant bonding (Ayers et al, 2006), a reduction in breastfeeding rates (Beck and Watson, 2010) and fear of childbirth in future pregnancies (Storksen et al, 2013).

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month