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Choobdarnezhad M, Amiri-Farahani L, Pezaro S. Maternal performance after childbirth and its predictors: a cross sectional study. BMC Pregnancy Childbirth 2024; 24:215. [PMID: 38519910 PMCID: PMC10960374 DOI: 10.1186/s12884-024-06412-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 03/12/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Birthing parents need to use specialized skills as the first caregiver of the newborn. Several factors may affect performance. Yet there is a paucity of research in this area, and evidence remains inconsistent. Consequently, this study aimed to determine maternal performance after childbirth and its predictors. METHODS This cross-sectional study was conducted with those (n = 450) who had given birth (< two months) and been referred for the vaccination of their newborn. The multi-stage sampling method was carried out from April 2022 to February 2023. Participants who met the inclusion criteria completed a demographic and obstetric information questionnaire, along with the childbirth experience 2 (CEQ2), Barkin maternal performance and maternal self-efficacy scales. Multiple linear regression was used to investigate the predictive effect of the independent variables of childbirth experience, maternal self-efficacy, demographic and obstetric variables on the dependent variable of maternal performance. RESULTS The mean age of the participants was 26.78 and the mean total score of maternal performance was 91.04 (0-120). The highest and lowest scores related to the 'maternal competence' and the 'maternal needs' domains, with mean score calculated at 77.51 and 72.81 respectively. 'Childbirth experience' and 'maternal self-efficacy' domains had a statistically significant relationship with maternal performance (P < 0.05). Among the predictive factors of maternal performance, the results of our linear regression demonstrated the variables of birth experience (B = 0.63), maternal self-efficacy (B = 1.53), spouse's employment status (B = 5.78 for worker level, B = 3.99 for employee level), the number of previous childbirth experiences (B = -8.46), frequency of receiving antenatal care (B = -6.68), length of stay in the birth suite (B = -2.22) and length of stay in the hospital (B = 2.84) remained in the model. 53.2% of changes in maternal performance can be explained by these independent variables. CONCLUSION The promotion of evidence-based, person-centered, and respectful perinatal care during pregnancy and childbirth are of paramount importance. Strategies to improve the experience of childbirth and self-efficacy are especially required to improve maternal performance in the postpartum period. Prenatal care aimed at improving maternal function after childbirth will be important in achieving this overall.
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Affiliation(s)
- Masoumeh Choobdarnezhad
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Amiri-Farahani
- Department of Reproductive Health and Midwifery, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, 1996713883, Iran.
| | - Sally Pezaro
- The Research Centre for Healthcare and Communities, Coventry University, Coventry, UK
- The University of Notre Dame, Notre Dame, Fremantle, Australia
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Delicate A, Ayers S. The impact of birth trauma on the couple relationship and related support requirements; a framework analysis of parents' perspectives. Midwifery 2023; 123:103732. [PMID: 37229840 DOI: 10.1016/j.midw.2023.103732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 04/19/2023] [Accepted: 05/16/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Ongoing distress following a traumatic birth experience, commonly known as birth trauma, can lead to post-traumatic stress symptoms. Experiencing birth trauma can affect personal well-being and impact the couple relationship. OBJECTIVE The present study aimed to explore the lived experience of the impact of birth trauma on the couple relationship and related support requirements. METHODS A purposive sample of men and women in the UK who had experienced birth as traumatic were recruited and interviewed remotely in 2021. Data were analysed using framework analysis in NVivo 12. RESULTS The sample (N=18) contained 9 women who were first time parents and 9 men; 5 of which were first time parents and 4 who had two children. Twelve themes are reported related to the impact of birth trauma on the couple relationship. Findings suggest the impact of birth trauma on the couple relationship can be negative and distressing, or for some lead to a strengthened relationship. Fourteen themes are reported related to associated birth trauma support. Negative aspects of support were reported in themes: unavailability of help from friends and family; unhelpful birth debriefing services; no personal awareness of birth trauma; absence of trauma validation from health care professionals; lack of awareness of the emotional needs of men; and barriers to accessing psychological services. Potential improvements to support included: supporting parents to understand the traumatic events; birth trauma informed antenatal preparation; improving access to specialist psychological services; and compassionate parent centred maternity services. CONCLUSIONS The impact of birth trauma on the couple relationship appears complex with both positive and negative affects reported. Current support for the impact of birth trauma on the couple relationship has perceived inadequacies for which improvements are proposed.
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Affiliation(s)
- Amy Delicate
- Research Assistant, Centre for Maternal and Child Health Research, City University of London.
| | - Susan Ayers
- Professor, Centre for Maternal and Child Health Research, City University of London
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Gökçe İsbir G, Yılmaz M, Thomson G. Using an emotion-focused approach in preventing psychological birth trauma. Perspect Psychiatr Care 2022; 58:1170-1176. [PMID: 34047362 DOI: 10.1111/ppc.12867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE This discussion article considers how an emotion-focused approach can be adopted to prevent psychological birth trauma and to optimize perinatal wellbeing for women and their families. CONCLUSION Emotion-focused approaches have a different perspective when compared to other classic psychotherapy methods. This approach may help women to resolve the negative impacts of psychological birth trauma; to prevent posttraumatic stress disorder onset; to lead to better results for mother and baby well-being; and may be cost effective. PRACTICE IMPLICATIONS Mental health nurses/midwives should receive education about emotion-focused approaches in addition to gaining competence in basic counseling skills so that they can utilize these approaches with women.
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Affiliation(s)
- Gözde Gökçe İsbir
- Midwifery Department, School of Health, Mersin University, Yenişehir, Mersin, Turkey
| | - Mualla Yılmaz
- Faculty of Nursing, Mental Health Nursing Department, Mersin University, Yenişehir, Mersin, Turkey
| | - Gill Thomson
- Maternal and Infant Nutrition and Nurture Unit, Perinatal Health Department, University of Central Lancashire, Preston, UK
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Midwives’ experiences of supporting women's mental health: a mixed-method study. Midwifery 2022; 111:103368. [DOI: 10.1016/j.midw.2022.103368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 03/07/2022] [Accepted: 05/09/2022] [Indexed: 11/23/2022]
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Thomson G, Diop MQ, Stuijfzand S, Horsch A. Policy, service, and training provision for women following a traumatic birth: an international knowledge mapping exercise. BMC Health Serv Res 2021; 21:1206. [PMID: 34742293 PMCID: PMC8571982 DOI: 10.1186/s12913-021-07238-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 10/21/2021] [Indexed: 12/23/2022] Open
Abstract
Background High numbers of women experience a traumatic birth, which can lead to childbirth-related post-traumatic stress disorder (CB-PTSD) onset, and negative and pervasive impacts for women, infants, and families. Policies, suitable service provision, and training are needed to identify and treat psychological morbidity following a traumatic birth experience, but currently there is little insight into whether and what is provided in different contexts. The aim of this knowledge mapping exercise was to map policy, service and training provision for women following a traumatic birth experience in different European countries. Methods A survey was distributed as part of the COST Action “Perinatal mental health and birth-related trauma: Maximizing best practice and optimal outcomes”. Questions were designed to capture country level data; care provision (i.e., national policies or guidelines for the screening, treatment and/or prevention of a traumatic birth, service provision), and nationally mandated pre-registration and post-registration training for maternity professionals. Results Eighteen countries participated. Only one country (the Netherlands) had national policies regarding the screening, treatment, and prevention of a traumatic birth experience/CB-PTSD. Service provision was provided formally in six countries (33%), and informally in the majority (78%). In almost all countries (89%), women could be referred to specialist perinatal or mental health services. Services tended to be provided by midwives, although some multidisciplinary practice was apparent. Seven (39%) of the countries offered ‘a few hours’ professional/pre-registration training, but none offered nationally mandated post-registration training. Conclusions A traumatic birth experience is a key public health concern. Evidence highlights important gaps regarding formalized care provision and training for care providers. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-07238-x.
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Affiliation(s)
- Gill Thomson
- School of Community Health & Midwifery, University of Central Lancashire, Preston, UK.
| | - Magali Quillet Diop
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
| | - Suzannah Stuijfzand
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland.,Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
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Roberts NJ, Jomeen J, Thomson G. Women's Experiences of the Coping With Birth Trauma:A Psychoeducational Group Support Program. INTERNATIONAL JOURNAL OF CHILDBIRTH 2021. [DOI: 10.1891/ijcbirth-d-20-00042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVEBetween 20%-50% of women experience birth as traumatic, with negative impacts for women, infants and families. Currently, there is a lack of evidence into supportive interventions to ameliorate women's adverse responses following a traumatic birth. In North-West UK, a 6-week psychoeducation group support program (Coping with Birth Trauma [CwBT]) was developed and delivered by two trained therapists. The course aimed to facilitate women's understanding of trauma, and to provide coping strategies; additional speakers were also invited to discuss specialist issues. The aim of this evaluation was to explore women's experiences and perceptions of the CwBT, and to identify recommendations for course development.METHODSFollowing university ethics approval, all the women who had attended a CwBT course (n = 3) were invited to take part in a telephone interview. Eight women out of a possible sample of 16 agreed to participate. Thematic analysis was used to analyse the interview data.RESULTSTwo themes and associated sub-themes describe the social, cognitive and instrumentalcomponents of the CwBT course (“Creating a difference”) and how the course facilitated growth and help-seeking behaviors (“Growth and renewal”). The final theme “complaints and recommendations” details critical reflections and suggestions for course development. Recommendations included speakers from different therapeutic backgrounds and more opportunities for contact with women at different stages of their trauma journey.CONCLUSIONSOverall, the course was well received with positive implications for health, wellbeing and family functioning. Further and large-scale studies to assess its effectiveness are needed.
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Havizari S, Ghanbari-Homaie S, Eyvazzadeh O, Mirghafourvand M. Childbirth experience, maternal functioning and mental health: how are they related? J Reprod Infant Psychol 2021; 40:399-411. [PMID: 33843380 DOI: 10.1080/02646838.2021.1913488] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Introduction: Childbirth experience is shaped by the labor and delivery process. The aim of this study was to investigate the relationship between childbirth experience, subsequent postpartum maternal functioning and mental health.Methods: A total of 483 mothers in the first 4-16 weeks postpartum participated in this cross-sectional study. The cluster random sampling method was used to select the participants. The Questionnaire for Assessing the Childbirth Experience, Mental Health Inventory, and the Barkin Index of Maternal Functioning were completed through interviews.Results: The mean childbirth experience, mental health, and maternal functioning scores were 1.6 (0.4), 79.1 (15.0), and 97.4 (13.0), respectively. There was a significant correlation between the total mental health and maternal functioning scores and all its subscales with childbirth experience scores (P<0.001). Results from the general linear model pointed to a significant correlation between maternal functioning and childbirth experience (P<0.001), as well as between receiving support for infant care (P<0.001) and family income adequacy (P=0.006). Mental health was also significantly correlated with childbirth experience (P<0.001), complete life satisfaction (P<0.001), and receiving support for infant care (P=0.025).Conclusion: Supportive care provision services may improve mothers' birth experiences, which leads to enhanced postpartum maternal functioning and mental health.
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Affiliation(s)
- Shiva Havizari
- Midwifery Counseling, Tabriz University of Medical Sciences, Student Research Center, Tabriz, Iran
| | - Solmaz Ghanbari-Homaie
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ommlbanin Eyvazzadeh
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Midwifery Department, Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Health care practitioners' views of the support women, partners, and the couple relationship require for birth trauma: current practice and potential improvements. Prim Health Care Res Dev 2020; 21:e40. [PMID: 33004100 PMCID: PMC7576522 DOI: 10.1017/s1463423620000407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AIM To examine health care practitioners' views of the support women, partners, and the couple relationship require when affected by birth trauma, barriers to gaining such support, and potential improvements. BACKGROUND Ongoing distress following psychologically traumatic childbirth, also known as birth trauma, can affect women, partners, and the couple relationship. Birth trauma can lead to post traumatic stress symptoms (PTSS) or disorder (PTSD). Whilst there is a clear system of care for a PTSD diagnosis, support for the more prevalent experience of birth trauma is not well-defined. METHOD An online survey of health care practitioners' views of the support parents require for birth trauma, barriers to accessing support, and potential improvements. Practitioners were recruited in 2018 and the sample for the results presented in the article ranged from 95 to 110. RESULTS Practitioners reported differing needs of support for women, partners, and the couple as a unit. There was correlation between practitioners reporting having the skills and knowledge to support couples and feeling confident in giving support. The support most commonly offered by practitioners to reduce the impact on the couple relationship was listening to the couple. However practitioners perceived the most effective support was referral to a debriefing service. Practitioners observed several barriers to both providing support and parents accessing support, and improvements to birth trauma support were suggested. CONCLUSIONS Practitioners indicate that some women, partners, and the couple as a unit require support with birth trauma and that barriers exist to accessing effective support. The support that is currently provided often conflicts with practitioners' perception of what is most effective. Practitioners indicate a need to improve the identification of parents who need support with birth trauma, and more suitable services to support them.
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Quinlivan J, Rowe H, Wischmann T, Thomson G, Stuijfzand S, Horsch A, Bittner A, Lennertz I, Takamatsu K, Benyamini Y, Tschudin S. Setting the global research agenda in psychosocial aspects of women's health - outcomes from ISPOG world conference at The Hague. J Psychosom Obstet Gynaecol 2020; 41:1-4. [PMID: 31805800 DOI: 10.1080/0167482x.2020.1695872] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Julie Quinlivan
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Australia
| | - Heather Rowe
- School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
| | - Tewes Wischmann
- Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg, Germany
| | - Gill Thomson
- Perinatal Health, Maternal and Infant Nutrition & Nurture Unit, University of Central Lancashire, Lancashire, UK
| | - Suzannah Stuijfzand
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne, Switzerland
| | - Antje Bittner
- University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Dresden, Germany
| | - Ilka Lennertz
- University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Dresden, Germany
| | - Kiyoshi Takamatsu
- Department of Obstetrics and Gynecology, Tokyo Dental College Ichikawa General Hospital, Tokyo, Japan
| | - Yael Benyamini
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Sibil Tschudin
- Department of Obstetrics and Gynecology, University Hospital Basel, Switzerland
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