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What is traumatic birth? A concept analysis and literature review

02 April 2016
27 min read
Volume 24 · Issue 4

Abstract

Background:

A number of women experience childbirth as traumatic. This experience can have enduring and potentially lifelong effects on both mental and physical health, and have implications for the woman's relationship with her baby, partner and family. It can also have implications for future decisions about pregnancy and birth. However, the meaning of the term ‘traumatic birth’ remains poorly defined. Clear understanding of the concept is critical to better underpin understanding and effectively evaluate women's experiences.

Objective:

To review the literature pertaining to ‘traumatic birth’ and produce a definition of the concept.

Methods:

The concept analysis framework of Walker and Avant (2011) was used. Electronic bibliographic databases CINAHL, Medline, PsycINFO and Cochrane were searched to find papers written in English and dated 1998–2015. From a narrative literature review, the defining attributes were ascertained, and model, borderline, related, contrary, invented and illegitimate cases were constructed. The antecedents and consequences were then identified and empirical referents determined.

Findings:

The apparent attributes of ‘traumatic birth’ are that a baby has emerged from the body of its mother at a gestation where survival was possible. This birth has involved events and/or care that have caused deep distress or disturbance to the mother, and the distress has outlived the immediate experience.

Conclusions:

‘Traumatic birth’ is a complex concept which is used to describe a series of related experiences of, and negative psychological responses to, childbirth. Physical trauma in the form of injury to the baby or mother may be involved, but is not a necessary condition.

Experiencing childbirth as a traumatic event is a factor that has been highlighted as contributing to poorer psychological outcomes for mothers. Up to 30% of women in the UK experience childbirth as a traumatic event, with many consequently going on to experience some form of anxiety, depression or post-traumatic stress disorder (PTSD) following childbirth (Slade, 2006; Ayers, 2014). When childbirth presents as a traumatic experience, it can have a profound effect on the lives of mothers, fathers (Nicholls and Ayers, 2007), their children (Allen, 1998) and family and friends (Beck, 2004a; Ayers et al, 2006). If left untreated, the effects can last many years (Forssén, 2012). Consequences of traumatic birth include enduring mental health problems (Beck, 2004a; Forssén, 2012), compromised maternal–infant relationships (Nicholls and Ayers, 2007), poorer-quality marital relationships (Ayers et al, 2006) and concomitant depression in partners (Nicholls and Ayers, 2007), and can present a challenge to future reproductive decisions (Fenech and Thomson, 2014).

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