From decline to recovery: a meta-synthesis of the psychosocial impact of a traumatic birth

Abstract

Abstract - Summary of Dissertation Background: Traumatic birth is a potential risk factor for the development of mental health problems that affect both mothers and their infants. These problems can include post-traumatic stress disorder (PTSD), depression, anxiety, and bonding and attachment issues. A birth can be traumatic for many reasons, including the need for medical interventions, such as the use of forceps or vacuum extraction, and by prolonged labour or difficult delivery. Despite considerable research about women experiencing depression, anxiety, or PTSD as result of traumatic birth, little research has been conducted that focuses on the impact these birth experiences have on the psychological and social wellbeing of women during the postpartum period. This therefore represents the first qualitative review that updates and extends our understanding of how traumatic births affect women after childbirth. Aim: This review aims to explore the psychosocial effect of traumatic birth on maternal wellbeing in the postpartum period, and builds on the work of Fenech and Thomson (2014) to provide an up-to-date expansion of their initial meta-synthesis. Objectives: To answer the aim, the following objectives were set:  To source relevant and up-to-date evidence related to the psychosocial effects of traumatic birth  To provide an up-to-date synthesis of the evidence related to the psychosocial effects of traumatic birth  To outline the similarities and differences between the findings of the current review (2023) and those reported in Fenech and Thomson (2014). Methodology: Initial manual searches of Google Scholar, PROSPERO, ProQuest, and OPENGREY were conducted to identify any unpublished reviews or those still being undertaken as part of thesis or dissertation work. The main searches were carried out systematically 6 on six databases including Medline, Embase, PsychINFO, CINAHL, and Maternity & Infant Care, from 2014 to the present. The quality of the included studies was evaluated with the CASP tool. Findings: Seventeen qualitative studies that met the selection criteria and focused on the impact of traumatic birth were included in this review. The studies ranged from high to low methodological quality and the data they contributed was synthesized using a meta￾ethnographic approach. Two themes emerged during the synthesis: “Being Out of Control", and "Taking Back Me". Conclusion: The review provides an update and expansion of the earlier evidence provided by Fenech and Thomson (2014) review, and found that traumatic births can have important negative as well as positive impacts on women's lives. The negative effects include post-traumatic stress disorder, anxiety, depression, and difficulty bonding with their baby. Positive outcomes include increased resilience, enhanced appreciation of life, and feeling more connected to their family. This review demonstrates the need for further research into the time it takes women to develop post-traumatic growth after traumatic births.