Many women experience psychological trauma during birth. A traumatic birth can impact on postnatal mental health and family relationships. It is important to understand how interpersonal factors influence women’s experience of trauma in order to inform the development of care that promotes optimal psychosocial outcomes. As part of a large mixed methods study, 748 women completed an online survey and answered the question ‘describe the birth trauma experience, and what you found traumatising’. Data relating to care provider actions and interactions were analysed using a six-phase inductive thematic analysis process. Four themes were identified in the data: ‘prioritising the care provider’s agenda’; ‘disregarding embodied knowledge’; ‘lies and threats’; and ‘violation’. Women felt that care providers prioritised their own agendas over the needs of the woman. This could result in unnecessary intervention as care providers attempted to alter the birth process to meet their own preferences. In some cases, women became learning resources for hospital staff to observe or practice on. Women’s own embodied knowledge about labour progress and fetal wellbeing was disregarded in favour of care provider’s clinical assessments. Care providers used lies and threats to coerce women into complying with procedures. In particular, these lies and threats related to the wellbeing of the baby. Women also described actions that were abusive and violent. For some women these actions triggered memories of sexual assault. Care provider actions and interactions can influence women’s experience of trauma during birth. It is necessary to address interpersonal birth trauma on both a macro and micro level. Maternity service development and provision needs to be underpinned by a paradigm and framework that prioritises both the physical and emotional needs of women. Care providers require training and support to minimise interpersonal birth trauma.

/pdf/women-s-descriptions-of-childbirth-trauma-relating-to-care-1bp7dxj8lb.pdf

Women’s descriptions of childbirth trauma relating to care provider actions and interactions

A negative experience in childbirth is associated with chronic maternal morbidities. The aim of this systematic review and meta-analysis was to identify currently available successful interventions to create a positive perception of childbirth experience which can prevent psychological birth trauma. Randomized controlled trials of interventions in pregnancy or labour which aimed to improve childbirth experience versus usual care were identified from 1994 to September 2016. Low risk pregnant or childbearing women were chosen as the study population. PEDRO scale and Cochrane risk of bias tool were used for quality assessment. Pooled effect estimates were calculated when more than two studies had similar intervention. If it was not possible to include a study in the meta-analysis, its data were summarized narratively. After screening of 7832 titles/abstracts, 20 trials including 22,800 participants from 12 countries were included. Successful strategies to create a positive perception of childbirth experience were supporting women during birth (Risk Ratio = 1.35, 95% Confidence Interval: 1.07 to 1.71), intrapartum care with minimal intervention (Risk Ratio = 1.29, 95% Confidence Interval:1.15 to 1.45) and birth preparedness and readiness for complications (Mean Difference = 3.27, 95% Confidence Interval: 0.66 to 5.88). Most of the relaxation and pain relief strategies were not successful to create a positive birth experience (Mean Difference = − 2.64, 95% Confidence Intervention: − 6.80 to 1.52). The most effective strategies to create a positive birth experience are supporting women during birth, intrapartum care with minimal intervention and birth preparedness. This study might be helpful in clinical approaches and designing future studies about prevention of the negative and traumatic birth experiences.

/pdf/creating-a-positive-perception-of-childbirth-experience-2jl3revcyo.pdf

Creating a positive perception of childbirth experience: systematic review and meta-analysis of prenatal and intrapartum interventions.

The association between disrespect and abuse of women during childbirth and postpartum depression: findings from the 2015 Pelotas birth cohort study.

Background: Up to 33% of women report a negative or traumatic childbirth experience. Given this high prevalence and its consistent association with adverse postpartum and child outcomes, it is essential to identify predictive factors and to improve the management of the childbirth experience. Objective: This systematic review explores and identifies risk and protective factors for women's subjective childbirth experience and birth satisfaction by reviewing original research. Methods: A systematic search was performed for childbirth experience literature on three online databases. Reviewed papers focused on women's subjective childbirth experience and its predictive factors. The articles were assessed with the Mixed Methods Appraisal Tool (MMAT). Results: Risk and protective factors are notably different depending on the study design, the country, or the method employed. The main risk factors are obstetric, such as emergency caesarean and highly perceived labour pain, and women's dissatisfaction with social support. The main protective factors are: obstetric, including highly perceived control during labour or satisfaction regarding partner's support. However, overall results are inconclusive for methodological or conceptual reasons. Conclusions: Several risk factors can be identified through pregnancy or childbirth. This underlines the importance of the quality of maternal interpersonal and professional relationships, especially with first-line perinatal health-care professionals, such as midwives.

Predictive factors of women's subjective perception of childbirth experience: a systematic review of the literature.

How does delivery method influence factors that contribute to women's childbirth experiences?

Post-Traumatic Stress Disorder after childbirth and the influence of maternity team care during labour and birth: A cohort study

BackgroundThe multitude of negative consequences of nurse burnout calls for interventions to protect the well-being of the individual nurses, patients, and hospital organizations. However, much is ...

Vulnerability and Stressors for Burnout Within a Population of Hospital Nurses: A Qualitative Descriptive Study:

Generic Crew Resource Management Training to Improve Non-technical Skills in Acute Care—Phase 1: An Interdisciplinary Needs Assessment Survey

Generic Crew Resource Management training to improve non-technical skills in acute care - Phase 2: A pre-post multicentric intervention study

In spite of being characterized by more highly educated professionals and more cutting-edge training facilities, equipment, and more research than ever, healthcare systems are still confronted with serious safety problems. In more than 70% of cases, serious and avoidable medical errors originate in so-called human factors or deficits in “nontechnical” skills—including communication, leadership, teamwork, situational awareness, and decision-making. A major reason behind slow improvement is the cumbersome, hierarchical organizational structure in many healthcare organizations that stand in the way of a safety culture, encourage a “blame culture,” and foster communication errors. Resolving these issues requires a fundamental cultural shift from an individual to a group focus where safety is the shared responsibility of all individual healthcare workers and the entire management team working in a hospital (or other healthcare organization). Because safe care relies on the collective individual expertise of team members as well as teamwork, the interdisciplinary performance of care teams goes hand in hand with the safety culture of the healthcare organization as a whole. Consequently, investments in multidisciplinary teams in teamwork training (i.e., Team Resource Management training) to build nontechnical skills are essential.

Team Resource Management and Quality of Care

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