1
|
Schobinger E, Vanetti M, Ramelet AS, Horsch A. First-time parents' perception of midwives' and other healthcare professionals' support behaviours: A qualitative study. Midwifery 2024; 135:104028. [PMID: 38795667 DOI: 10.1016/j.midw.2024.104028] [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: 06/05/2023] [Revised: 05/13/2024] [Accepted: 05/15/2024] [Indexed: 05/28/2024]
Abstract
PROBLEM Parents often report not being satisfied with the support received from midwives and nurses during their postpartum hospital stay. BACKGROUND Social support is an important protective factor during the transition to parenthood. However, little is known on how first-time parents perceived the behaviours demonstrated by healthcare professionals to support them. OBJECTIVE To describe social support behaviours of midwives and nurses as perceived by first-time parents during the early postpartum period. METHODS This qualitative study used individual semi-structured interviews to collect data. A purposeful sample of first-time parents staying on the postpartum ward of a Swiss university hospital were included. Thematic analysis was performed to identify themes and sub-themes. FINDINGS A total of 26 parents (15 mothers and 11 fathers) were interviewed. Parents reported behaviours perceived either as positive or negative. These behaviours were summarized into five themes: "Welcoming parents on the postpartum ward", "Establishing a partnership with parents", "Guiding parents in acquiring their new parenting role", "Caring for parent's emotions", and "Creating a peaceful environment". DISCUSSION AND CONCLUSION This study reported a wide variety of professional support behaviours. Behaviours promoting individualised care and related to empowering parents in their infant care were perceived as helpful by parents. Midwives and nurses should be aware of the way they provide support, as this shapes the early postpartum experience of first-time parents. Being sufficiently staffed and being well-trained, especially in providing interpersonal support, could help midwives and nurses provide better sensitive individualised care.
Collapse
Affiliation(s)
- Elisabeth Schobinger
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
| | - Mélanie Vanetti
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
| | - Anne-Sylvie Ramelet
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland; Department Woman-Mother-Child, University Hospital, Lausanne, Switzerland.
| |
Collapse
|
2
|
Hüner B, Schmiedhofer M, Derksen C, Polasik A, Janni W, Reister F, Lippke S. ["Helplessness, Giving up of Any Self-Responsibility and Self-Determination" - a Qualitative Evaluation of Traumatizing Birth Experiences in Relation to Birth Mode]. Z Geburtshilfe Neonatol 2023. [PMID: 36921615 DOI: 10.1055/a-2039-3017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
Background Childbirth is combined with emotional challenges and individual anxiety. Unexpected birth experiences can trigger stress reactions and even post-traumatic stress disorders. Aim of the study The aim of the study was the qualitative evaluation of stressful perceived birth experiences and desired interventions.Methods A content-analytic evaluation of 117 free-text answers was conducted regarding stressful birth experiences and desired interventions using categories and frequencies in relation to birth mode.Findings Five themes emerged from the structured free text analysis: 1) Stressful experiences describing fear concerning the child and separation from the child after an emergency caesarean section; 2) Inadequate communication after an operative vaginal birth and unplanned caesarean section; 3) Feelings of failure and guilt after unplanned birth modes; 4) Helplessness with loss of personal control and the feeling of being at the mercy after an emergency caesarean section; 5) Inadequate support due to the absence of empathy or insufficient care. Expected interventions include immediate debriefing and professional psychological support.Conclusion Women-centered communication during childbirth and debriefing of stressful birth experiences are significant interventions for strengthening maternal well-being and mental health. They can have a positive impact on the development of a healthy mother-child relationship.
Collapse
Affiliation(s)
- Beate Hüner
- Frauenklinik, Universitätsklinikum Ulm, Ulm, Germany
| | | | - Christina Derksen
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany
| | | | | | - Frank Reister
- Frauenklinik, Universitätsklinikum Ulm, Ulm, Germany
| | - Sonia Lippke
- Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany
| |
Collapse
|
3
|
Carter J, Bick D, Gallacher D, Chang Y. Mode of birth and development of maternal postnatal post-traumatic stress disorder: A mixed-methods systematic review and meta-analysis. Birth 2022; 49:616-627. [PMID: 35561055 PMCID: PMC9790679 DOI: 10.1111/birt.12649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) affects approximately 3% of women in the postnatal period, but less is known about risk factors for PTSD than other postnatal mental illnesses. This review aimed to analyze the literature on the impact of mode of birth on postnatal PTSD. METHODS Searches were undertaken of CINAHL, the Cochrane Library, MEDLINE, PsycINFO, and Scopus for studies investigating the link between mode of birth and postnatal PTSD in high-resource countries from January 1990 to February 2021. Quantitative and qualitative data were collected and synthesized. Meta-analysis was performed with four of the studies, and the rest were analyzed narratively. RESULTS Twelve quantitative studies, presenting data on 5567 women, and two qualitative studies, with 92 women, were included in the review. Most studies found a significant relationship between mode of birth and maternal PTSD symptoms. Meta-analysis found cesarean birth was more closely associated with PTSD than vaginal delivery (VD) (P = 0.005), emergency cesarean birth (EmCB) more than elective cesarean birth (ElCB) (P < 0.001), instrumental vaginal delivery (IVD) more than spontaneous vaginal delivery (SVD) (P < 0.001), and EmCB more than SVD (P < 0.001). Women who developed PTSD after EmCB felt less in control and less supported than those who did not develop it after the same procedure. Request for repeat ElCB appeared more common among women with pre-existing postnatal PTSD, but this may subsequently leave them feeling dissatisfied and their fears of childbirth unresolved. CONCLUSIONS Modes of birth involving emergency intervention may be risk factors for the development of postnatal PTSD. Ensuring that women feel supported and in control during emergency obstetric interventions may mediate against this risk.
Collapse
Affiliation(s)
- Jemima Carter
- Faculty of Life Sciences and MedicineKing's College LondonLondonUK,St Richard's HospitalChichesterUK
| | - Debra Bick
- Warwick Medical SchoolUniversity of WarwickWarwickUK
| | | | - Yan‐Shing Chang
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative CareKing's College LondonLondonUK
| |
Collapse
|
4
|
Schobinger E, Vanetti M, Ramelet AS, Horsch A. Social support needs of first-time parents in the early-postpartum period: A qualitative study. Front Psychiatry 2022; 13:1043990. [PMID: 36590631 PMCID: PMC9794858 DOI: 10.3389/fpsyt.2022.1043990] [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: 09/14/2022] [Accepted: 11/23/2022] [Indexed: 12/15/2022] Open
Abstract
Background The early postpartum period is a critical time for first-time parents as they adapt to their new role. Perceived lack of social support is a risk factor for developing mental health problems. Insufficient or inappropriate professional support for both parents has been reported by many studies. Social support that appropriately meets parents' needs is an important protective factor for parents' wellbeing; however, little is known about the social support needs of both first-time parents. Aims and objectives To describe both first-time parents' formal social support needs in the early postpartum period. Method Individual semi-structured interviews were conducted with first-time parents recruited on the postpartum ward of a Swiss university hospital. Thematic analysis was used to identify themes and sub-themes. Results Fifteen mothers and eleven fathers were interviewed. Twelve themes were identified. Mothers' themes were "experiencing postpartum changes," "creation of a family unit," "self-esteem," "emotional needs," "difficulty in communicating their needs," and "the postpartum stay." Fathers' themes were "to be included in care procedures on the postpartum ward," "to be reassured," "to anticipate their postpartum stay" and "to consider their need as non-priority." Parental shared needs were: "to care for their newborn," and "returning home." Conclusion Mothers' and fathers' needs differed. Mothers needed more emotional support than fathers and fathers considered themselves as the main support for their partner. Fathers wanted to be integrated in the care of their newborn.
Collapse
Affiliation(s)
- Elisabeth Schobinger
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
| | - Mélanie Vanetti
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
| | - Anne-Sylvie Ramelet
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland.,Department Woman-Mother-Child, University Hospital, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland.,Department Woman-Mother-Child, University Hospital, Lausanne, Switzerland
| |
Collapse
|
5
|
Bam V, Lomotey AY, Kusi-Amponsah Diji A, Budu HI, Bamfo-Ennin D, Mireku G. Factors influencing decision-making to accept elective caesarean section: A descriptive cross-sectional study. Heliyon 2021; 7:e07755. [PMID: 34430742 PMCID: PMC8365447 DOI: 10.1016/j.heliyon.2021.e07755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/09/2021] [Accepted: 08/09/2021] [Indexed: 11/26/2022] Open
Abstract
Elective caesarean sections (CS) that have medical indications contribute to better pregnancy outcomes but women have to consent for the procedure to be performed within reasonable time limits for the desired outcomes. This study aimed to determine the factors that influence women's decision-making and the duration of the decision-making process to accept primary or repeat elective CS in a district hospital in Ghana. A descriptive cross-sectional study was conducted among 163 purposively-sampled postnatal women in a hospital, who had experienced a CS. A questionnaire was used to collect data after the women gave their consent to participate. Data was analyzed using SPSS version 25.0 and presented using appropriate descriptive statistics. Chi-square test of independence was done to determine the association between any two categorical variables. Major factors that influenced women's decision-making to accept elective CS were support from their husband/partner/relatives (39.3 %), their baby's life being at risk (24.5 %), history of previous CS and knowledge about the procedure (19.6 %). Age and parity had significant relationship with the influencing factors. However, age was only significant for the influence of husband/partner/relative in the decision-making to accept CS (p < 0.01). Age (R2 = 0.19, p < 0.001); previous CS (R2 = 0.14, p < 0.001) are the major predictors of the duration of the decision-making process. Women's decision-making in consultation with relatives is the main influencer to accept elective caesarean section. There is the need to involve relatives during the antenatal care period in order for younger women in particular to be readily supported to make timely decisions to avoid preventable complications and allay client's fears.
Collapse
Affiliation(s)
- Victoria Bam
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Ghana
| | | | | | - Hayford Isaac Budu
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Ghana
| | - Dorothy Bamfo-Ennin
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Ghana
| | - Georgina Mireku
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Ghana
| |
Collapse
|
6
|
Høgh S, Navne LE, Johansen M, Svendsen MN, Sorensen JL. Postnatal consultations with an obstetrician after critical perinatal events: a qualitative study of what women and their partners experience. BMJ Open 2020; 10:e037933. [PMID: 32948568 PMCID: PMC7500287 DOI: 10.1136/bmjopen-2020-037933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The objective of this study was to explore women's and their partners' experiences with attending postnatal consultations with an obstetrician after critical perinatal events. DESIGN Qualitative interview study. We did semi-structured individual narrative interviews exploring the lived experiences. Interviews were analysed using a phenomenological approach and the thematic analysis was validated by a transdisciplinary group of anthropologists, obstetricians and a midwife. SETTING Department of obstetrics at a large hospital in Denmark. PARTICIPANTS We did a qualitative study with 17 participants (10 women and 7 partners) who had experienced critical perinatal events. RESULTS Five major themes were identified: (1) a need to gain understanding and make sense of the critical perinatal events, (2) a need for relational continuity, (3) the importance of discussing emotional effects as well as physical aspects of occurred events, (4) preparing for future pregnancies and (5) closure of the story.Most of the participants emphasised the importance of knowing the obstetrician undertaking the postnatal consultation. The majority of the participants described a need to discuss the emotional effects of the experience as well as the physical aspects of occurred events. The postnatal consultation served as an approach to obtain a positive closure of their birth story and to feel confident about potential future pregnancies. CONCLUSIONS This interview-based study suggests that postnatal consultation with an obstetrician might be an important tool for women and their partners in understanding the course of events during the critical birth experience and in processing it and preparing for future pregnancies. It appears to be important to assign an obstetrician whom they already know and to encourage them to discuss not only physical aspects of what happened but also the emotional effects of the experience.
Collapse
Affiliation(s)
- Stinne Høgh
- Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark
| | - Laura Emdal Navne
- The Danish Centre for Social Science Research, VIVE, Copenhagen, Denmark
- Public Health, Faculty of Health Sciences, University of Copenhagen, Kobenhavn, Denmark
| | | | | | - Jette Led Sorensen
- Juliane Marie Centre for Children, Women and Reproduction Section 4074, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
7
|
Benton M, Salter A, Tape N, Wilkinson C, Turnbull D. Women's psychosocial outcomes following an emergency caesarean section: A systematic literature review. BMC Pregnancy Childbirth 2019; 19:535. [PMID: 31888530 PMCID: PMC6937939 DOI: 10.1186/s12884-019-2687-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 12/17/2019] [Indexed: 11/10/2022] Open
Abstract
Background Given the sudden and unexpected nature of an emergency caesarean section (EmCS) coupled with an increased risk of psychological distress, it is particularly important to understand the psychosocial outcomes for women. The aim of this systematic literature review was to identify, collate and examine the evidence surrounding women’s psychosocial outcomes of EmCS worldwide. Methods The electronic databases of EMBASE, PubMed, Scopus, and PsycINFO were searched between November 2017 and March 2018. To ensure articles were reflective of original and recently published research, the search criteria included peer-reviewed research articles published within the last 20 years (1998 to 2018). All study designs were included if they incorporated an examination of women’s psychosocial outcomes after EmCS. Due to inherent heterogeneity of study data, extraction and synthesis of both qualitative and quantitative data pertaining to key psychosocial outcomes were organised into coherent themes and analysis was attempted. Results In total 17,189 articles were identified. Of these, 208 full text articles were assessed for eligibility. One hundred forty-nine articles were further excluded, resulting in the inclusion of 66 articles in the current systematic literature review. While meta-analyses were not possible due to the nature of the heterogeneity, key psychosocial outcomes identified that were negatively impacted by EmCS included post-traumatic stress, health-related quality of life, experiences, infant-feeding, satisfaction, and self-esteem. Post-traumatic stress was one of the most commonly examined psychosocial outcomes, with a strong consensus that EmCS contributes to both symptoms and diagnosis. Conclusions EmCS was found to negatively impact several psychosocial outcomes for women in particular post-traumatic stress. While investment in technologies and clinical practice to minimise the number of EmCSs is crucial, further investigations are needed to develop effective strategies to prepare and support women who experience this type of birth.
Collapse
Affiliation(s)
- Madeleine Benton
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia.
| | - Amy Salter
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Nicole Tape
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Chris Wilkinson
- Maternal Fetal Medicine, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Deborah Turnbull
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| |
Collapse
|
8
|
Husby AE, van Duinen AJ, Aune I. Caesarean birth experiences. A qualitative study from Sierra Leone. SEXUAL & REPRODUCTIVE HEALTHCARE 2019; 21:87-94. [DOI: 10.1016/j.srhc.2019.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 05/03/2019] [Accepted: 06/10/2019] [Indexed: 10/26/2022]
|
9
|
Patterson J, Hollins Martin C, Karatzias T. PTSD post-childbirth: a systematic review of women's and midwives' subjective experiences of care provider interaction. J Reprod Infant Psychol 2018; 37:56-83. [PMID: 30114935 DOI: 10.1080/02646838.2018.1504285] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Review primary research regarding PTSD Post-Childbirth (PTSD-PC) that focussed on Quality of Provider Interaction (QPI) from the perspective of women who developed PTSD-PC, or midwives. BACKGROUND Up to 45% of women find childbirth traumatic. PTSD-PC develops in 4% of women (18% in high-risk groups). Women's subjective experiences of childbirth are the most important risk factor in the development of PTSD-PC, with perceived QPI being key. METHODS A systematic search was performed for PTSD-PC literature. Reviewed papers focussed on either women's subjective childbirth experiences, particularly QPI, or midwives' perspectives on QPI. Study quality was assessed using the Critical Appraisal Skills Programme (CASP) tools, and a narrative synthesis of findings produced. RESULTS Fourteen studies were included. Three features of QPI contribute towards developing PTSD-PC: interpersonal factors; midwifery care factors; and lack of support. CONCLUSION QPI is a significant factor in the development of PTSD-PC and the identified key features of QPI have potential to be modified by midwives. The development of guidelines for midwives should be grounded on evidence highlighted in this review, along with further high-quality qualitative research exploring QPI from the perspective of women with PTSD-PC, but also midwives' knowledge and needs regarding their role within QPI.
Collapse
Affiliation(s)
- Jenny Patterson
- a Edinburgh Napier University , Edinburgh , City of Edinburgh , Scotland
| | | | - Thanos Karatzias
- a Edinburgh Napier University , Edinburgh , City of Edinburgh , Scotland
| |
Collapse
|
10
|
Women's self-reported experience of unplanned caesarean section: Results of a Swedish study. Midwifery 2017; 50:253-258. [PMID: 28505479 DOI: 10.1016/j.midw.2017.04.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 03/10/2017] [Accepted: 04/26/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND women´s experience of emergency caesarean section is often described as less positive compared to a vaginal birth or a planned caesarean section. Midwifery care for women where deviations from a normal birth process are present is a challenge. The aim of study was to compare self-reported birth outcomes for women undergoing birth through spontaneous onset of labour between those who actually had a vaginal birth and those who eventually had an emergency caesarean section. DESIGN AND SETTING the study was part of a prospective longitudinal cohort study of parents' experiences, attitudes, and beliefs related to childbirth. METHOD AND FINDINGS questionnaires were answered by 870 women in midpregnancy, two months postpartum and one year after birth. 766 women (88%) had a vaginal birth, and 104 (12%) had an emergency caesarean section. The most common indications of emergency caesarean section were dystocia, foetal distress, and malpresentation. Women in the emergency caesarean group were more likely to be primiparous (59.6%) and have a body mass index > 30 (10.7%). Childbirth fear was twice as common among these women, and they were more likely to have preferred a caesarean delivery when asked about birth preference in the middle of pregnancy (OR 3.7, Cl 1.8-7.5). Induction of labour (OR 2.5, Cl 1.6-4.0), the use of oxytocin for augmentation (OR 1.9, Cl 1.3-2.9), and the use of epidural as pain relief during labour (OR 5.6, Cl 3.6-8.7) were more common among women having an emergency caesarean section. Transport of the new-born to a neonatal intensive care unit was three times as common. More than a third (37%) of the women in the caesarean group preferred a caesarean section in case of another birth. Childbirth fear was more common one year after birth with 32% of these women describing their fear as moderate or strong (OR 3.6, CI 2.1-6.0). KEY CONCLUSIONS women undergoing emergency caesarean section are more likely to experience fear and to have a negative birth experience. It is essential for the midwife to promote a sense of control, involve the woman in the procedure, and create security in a threatening situation. This is made possible in relationship characterized by mutuality, trust, on-going dialogue, shared responsibility, and enduring presence.
Collapse
|
11
|
De Schepper S, Vercauteren T, Tersago J, Jacquemyn Y, Raes F, Franck E. Post-Traumatic Stress Disorder after childbirth and the influence of maternity team care during labour and birth: A cohort study. Midwifery 2016; 32:87-92. [DOI: 10.1016/j.midw.2015.08.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 08/22/2015] [Accepted: 08/28/2015] [Indexed: 10/23/2022]
|
12
|
Iles J, Pote H. Postnatal posttraumatic stress: A grounded theory model of first-time mothers’ experiences. J Reprod Infant Psychol 2015. [DOI: 10.1080/02646838.2015.1030732] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
13
|
Abstract
An emergent cesarean delivery is performed to immediately intervene to improve maternal or fetal outcome for such indications as fetal distress, prolapsed cord, maternal hemorrhage from previa or trauma, uterine rupture, and complete placental abruption. It is paramount to reduce morbidity and mortality by preparing health care providers for special precautions.
Collapse
|
14
|
Andersen LB, Melvaer LB, Videbech P, Lamont RF, Joergensen JS. Risk factors for developing post-traumatic stress disorder following childbirth: a systematic review. Acta Obstet Gynecol Scand 2012; 91:1261-72. [PMID: 22670573 DOI: 10.1111/j.1600-0412.2012.01476.x] [Citation(s) in RCA: 199] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Approximately 1-2% of women suffer from post-traumatic stress disorder (PTSD) postnatally. This review aims to elucidate how women at risk can be identified. METHODS A systematic search of the published literature was carried out using the MEDLINE database (November 2003 to 29 October 2010) with both MeSH terms and free text. Thirty-one studies were considered appropriate for qualitative synthesis. Articles were included on the basis of (a) publication pertaining to PTSD following childbirth, (b) study carried out in Western Europe and (c) publication written in English. The results were primarily based on observational studies. The literature was thoroughly read and results were compiled. Furthermore, a novel quality rating system was employed to minimize the impact of bias. RESULTS Subjective distress in labor and obstetrical emergencies were the most important risk factors. Infant complications, low support during labor and delivery, psychological difficulties in pregnancy, previous traumatic experiences, and obstetrical emergencies were identified as risk factors. CONCLUSIONS We have identified factors both strongly associated and non-associated with PTSD following childbirth. While the literature is limited by methodological shortcomings, a hypothesis regarding the development of PTSD is outlined, and recommendations with respect to screening and future research are provided.
Collapse
Affiliation(s)
- Louise B Andersen
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | | | | | | | | |
Collapse
|