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Benyamini Y, Delicate A, Ayers S, Dikmen-Yildiz P, Gouni O, Jonsdottir SS, Karlsdottir SI, Kömürcü Akik B, Leinweber J, Murphy-Tighe S, Pajalic Z, Riklikiene O, Limmer CM. Key dimensions of women's and their partners' experiences of childbirth: A systematic review of reviews of qualitative studies. PLoS One 2024; 19:e0299151. [PMID: 38551936 PMCID: PMC10980232 DOI: 10.1371/journal.pone.0299151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 02/06/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND The World Health Organization 2018 intrapartum guideline for a positive birth experience emphasized the importance of maternal emotional and psychological well-being during pregnancy and the need for safe childbirth. Today, in many countries birth is safe, yet many women report negative and traumatic birth experiences, with adverse effects on their and their families' well-being. Many reviews have attempted to understand the complexity of women's and their partners' birth experience; however, it remains unclear what the key dimensions of the birth experience are. OBJECTIVE To synthesize the information from reviews of qualitative studies on the experience of childbirth in order to identify key dimensions of women's and their partners' childbirth experience. METHODS Systematic database searches yielded 40 reviews, focusing either on general samples or on specific modes of birth or populations, altogether covering primary studies from over 35,000 women (and >1000 partners) in 81 countries. We appraised the reviews' quality, extracted data and analysed it using thematic analysis. FINDINGS Four key dimensions of women's and partners' birth experience (covering ten subthemes), were identified: 1) Perceptions, including attitudes and beliefs; 2) Physical aspects, including birth environment and pain; 3) Emotional challenges; and 4) Relationships, with birth companions and interactions with healthcare professionals. In contrast with the comprehensive picture that arises from our synthesis, most reviews attended to only one or two of these dimensions. CONCLUSIONS The identified key dimensions bring to light the complexity and multidimensionality of the birth experience. Within each dimension, pathways leading towards negative and traumatic birth experiences as well as pathways leading to positive experiences become tangible. Identifying key dimensions of the birth experience may help inform education and research in the field of birth experiences and gives guidance to practitioners and policy makers on how to promote positive birth experiences for women and their partners.
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Affiliation(s)
- Yael Benyamini
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Amy Delicate
- Centre for Maternal and Child Health Research, City, University of London, London United Kingdom
| | - Susan Ayers
- Centre for Maternal and Child Health Research, City, University of London, London United Kingdom
| | - Pelin Dikmen-Yildiz
- Department of Psychology, Fen—Edebiyat Fakültesi, Cumhuriyet Mahallesi, Kirklareli University, Kırklareli, Turkey
| | - Olga Gouni
- Cosmoanelixis, Prenatal & Life Sciences Educational Organization, Nea Ionia, Athens, Greece
| | | | | | - Burcu Kömürcü Akik
- Department of Psychology, Faculty of Languages and History-Geography, Ankara University, Ankara, Turkey
| | - Julia Leinweber
- Institute of Midwifery, Charité University of Medicine, Berlin, Germany
| | - Sylvia Murphy-Tighe
- Department of Nursing & Midwifery, Health Sciences Building, University of Limerick, Ireland
| | | | - Olga Riklikiene
- Faculty of Nursing, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Claudia Maria Limmer
- Department of Nursing and Management, Faculty of Business and Social Sciences, Hamburg University of Applied Sciences, Hamburg, Germany
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Limmer CM, Stoll K, Vedam S, Leinweber J, Gross MM. Measuring disrespect and abuse during childbirth in a high-resource country: Development and validation of a German self-report tool. Midwifery 2023; 126:103809. [PMID: 37689053 DOI: 10.1016/j.midw.2023.103809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 06/27/2023] [Accepted: 08/29/2023] [Indexed: 09/11/2023]
Abstract
INTRODUCTION Increasing evidence on disrespect and abuse during childbirth has led to growing concern about the quality of care childbearing women are experiencing. To provide quantitative evidence of disrespect and abuse during childbirth services in Germany a validated measurement tool is needed. RESEARCH AIM The aim of this research project was the development and psychometric validation of a survey tool in the German language that measures disrespect and abuse of women during childbirth. METHODS A survey tool was created including the following measures: German adaptations of the short and long form of the "Mothers on Respect" (MOR) index (MOR-7 and MOR-G); the "Mothers' Autonomy in Decision Making" (MADM) scale; a mistreatment-index (MIST-I) comprising indicators of mistreatment during childbirth; and a set of items that measure experiences of discrimination during maternity care. Internal consistency reliability and construct validity of the scales were assessed using Cronbach's alpha, unweighted least squares factor analysis and non-parametric correlation analysis with a scale that measures a related construct, the Posttraumatic Symptom Scale - Self Report (PSS-SR) scale. We distributed the survey online, recruiting through snowball sampling via social media. A selection bias towards women who had experienced disrespect and abuse during their birth was intended and expedient for tool validation. The final sample of participants (n = 2045) had given birth in Germany between 2009 and 2018. FINDINGS More than 77% of the study participants reported at least one form of mistreatment with non-consented care being the most commonly reported type of mistreatment, followed by physical violence, violation of physical privacy, verbal abuse and neglect. All included scales showed good psychometric properties with high Cronbach's alphas (0.95 for both MOR versions and 0.96 for MADM). Factor analysis generated one factor scales with high factor loadings (0.75 to 0.92 for MOR-7; 0.37 to 0.90 for MOR-G and 0.83 to 0.92 for MADM). MOR-7, MOR-G, MADM and MIST-I scores were significantly (p<0.001) correlated with PSS-SR scores (Spearman's rho -0.70, -0.61 and 0.68 for MOR-G, MADM and the MIST-I, respectively). CONCLUSIONS This study presents a valid and reliable instrument for the quantitative assessment of disrespect and abuse during childbirth in Germany. Childbearing women's experiences of disrespect and abuse are a relevant phenomenon in German hospital based maternity care. Disrespect and abuse during childbirth appear to contribute to post-traumatic symptoms and may be associated with severe mental health problems postpartum.
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Affiliation(s)
- Claudia M Limmer
- Hannover Medical School, Midwifery Research and Education Unit, Carl-Neuberg-Str. 1, Hannover D-30625, Germany; Department Nursing and Management, Faculty of Business and Social Sciences, Hamburg University of Applied Science, Alexanderstr. 1, Hamburg D-20099, Germany
| | - Kathrin Stoll
- Hannover Medical School, Midwifery Research and Education Unit, Carl-Neuberg-Str. 1, Hannover D-30625, Germany; UBC Midwifery, Faculty of Medicine, University of British Columbia, 304-5950 University Boulevard, Vancouver, BC V6T 1Z3, Canada
| | - Saraswathi Vedam
- UBC Midwifery, Faculty of Medicine, University of British Columbia, 304-5950 University Boulevard, Vancouver, BC V6T 1Z3, Canada
| | - Julia Leinweber
- Institute of Midwifery, University Medicine Berlin, Charite, Oudenarder Strasse 16, Berlin 13347, Germany
| | - Mechthild M Gross
- Hannover Medical School, Midwifery Research and Education Unit, Carl-Neuberg-Str. 1, Hannover D-30625, Germany.
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Weidner K, Bartmann C, Leinweber J. [Traumatic childbirth and trauma-sensitive obstetric support]. Nervenarzt 2023; 94:811-820. [PMID: 37351670 DOI: 10.1007/s00115-023-01510-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/14/2023] [Indexed: 06/24/2023]
Abstract
Childbirth can be a very happy and empowering experience for women but also one of suffering and despair. Biographical traumatic experiences, especially sexual, physical and emotional violence, are risk factors for a traumatic childbirth experience with the danger of subsequent trauma sequelae and impaired mother-child bonding; however, obstetrically indicated interventions or poor communication in the delivery room can also primarily be experienced as traumatic.In recent years, policies affecting traumatic childbirth experience have been controversially and sometimes emotionally discussed. In the clinical obstetric routine there is often a fine line between medically necessary rapid interventions and emotionally supportive trauma-sensitive and preventive obstetric care. The following article addresses the causes and prevention strategies of traumatic childbirth experiences from obstetric, midwifery and psychotherapeutic perspectives.
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Affiliation(s)
- Kerstin Weidner
- Klinik und Poliklinik für Psychotherapie und Psychosomatik, Medizinische Fakultät, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
| | - Catharina Bartmann
- Frauenklinik und Poliklinik, Universitätsklinikum Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Deutschland
| | - Julia Leinweber
- Institut für Hebammenwissenschaft, Charité Universitätsmedizin Berlin, Virchowweg 23, 10117, Berlin, Deutschland
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Weidner K, Bartmann C, Leinweber J. Erratum zu: Traumatische Geburt und traumasensible Geburtsbegleitung. Nervenarzt 2023; 94:821. [PMID: 37522897 DOI: 10.1007/s00115-023-01536-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Affiliation(s)
- Kerstin Weidner
- Klinik und Poliklinik für Psychotherapie und Psychosomatik, Medizinische Fakultät, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
| | - Catharina Bartmann
- Frauenklinik und Poliklinik, Universitätsklinikum Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Deutschland
| | - Julia Leinweber
- Institut für Hebammenwissenschaft, Charité Universitätsmedizin Berlin, Virchowweg 23, 10117, Berlin, Deutschland
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Kuipers YJ, Thomson G, Goberna-Tricas J, Zurera A, Hresanová E, Temesgenová N, Waldner I, Leinweber J. The social conception of space of birth narrated by women with negative and traumatic birth experiences. Women Birth 2023; 36:e78-e85. [PMID: 35514007 DOI: 10.1016/j.wombi.2022.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/14/2022] [Accepted: 04/18/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Many women experience giving birth as a negative or even as a traumatic event. Birth space and its occupants are fundamentally interconnected with negative and traumatic experiences, highlighting the importance of the social space of birth. AIM To explore experiences of women who have had a negative or traumatic birth to identify the value, sense and meaning they assign to the social space of birth. METHODS A feminist standpoint theory guided the research. Secondary discourse analysis of 51 qualitative data sets/transcripts from Dutch and Czech Republic postpartum women and 551 free-text responses of the Babies Born Better survey from women in the United Kingdom, Netherlands, Belgium, Germany, Austria, Spain, and the Czech Republic. FINDINGS Three themes and associated sub-themes emerged: 1. The institutional dimension of social space related to staff-imposed boundaries, rules and regulations surrounding childbirth, and a clinical atmosphere. 2. The relational dimension of social space related to negative women-healthcare provider interactions and relationships, including notions of dominance, power, authority, and control. 3. The personal dimension of social space related to how women internalised and were affected by the negative social dimensions including feelings of faith misplaced, feeling disconnected and disembodied, and scenes of horror. DISCUSSION/CONCLUSION The findings suggest that improving the quality of the social space of birth may promote better birth experiences for women. The institutional, relational, and personal dimensions of the social space of birth are key in the planning, organisation, and provision of maternity care.
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Affiliation(s)
- Yvonne J Kuipers
- Artesis Plantijn University College, Noorderplaats 2, 2000 Antwerp, Belgium; Edinburgh Napier University, School of Health and Social Care, Sighthill Court, Edinburgh EH11 4BN, Scotland, United Kingdom.
| | - Gill Thomson
- School of Community Health & Midwifery, University of Central Lancashire, Preston, United Kingdom.
| | - Josefina Goberna-Tricas
- University of Barcelona, Faculty of Medicine and Health Sciences, Bellvitge Health Sciences Campus, Carrer de la Feixa Llarga, s/n. 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Alba Zurera
- University of Barcelona, Faculty of Law, Avinguda Diagonal, 684, 08028 Barcelona, Spain.
| | - Ema Hresanová
- Charles University, Faculty of Social Sciences, U Krize 8, 158 00 Prague, Czech Republic.
| | - Natálie Temesgenová
- Charles University, Faculty of Social Sciences, U Krize 8, 158 00 Prague, Czech Republic.
| | - Irmgard Waldner
- Universitätsklinik Graz, Auenbruggerplatz 14, 8036 Graz, Austria.
| | - Julia Leinweber
- Institute for Midwifery, Charite Universitätsmedizin Berlin, Berlin, Germany.
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Leinweber J, Fontein-Kuipers Y, Thomson G, Karlsdottir SI, Nilsson C, Ekström-Bergström A, Olza I, Hadjigeorgiou E, Stramrood C. Developing a woman-centered, inclusive definition of traumatic childbirth experiences: A discussion paper. Birth 2022; 49:687-696. [PMID: 35403241 DOI: 10.1111/birt.12634] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/18/2022] [Accepted: 03/08/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Many women experience giving birth as traumatic. Although women's subjective experiences of trauma are considered the most important, currently there is no clear inclusive definition of a traumatic birth to help guide practice, education, and research. AIM To formulate a woman-centered, inclusive definition of a traumatic childbirth experience. METHODS After a rapid literature review, a five-step process was undertaken. First, a draft definition was created based on interdisciplinary experts' views. The definition was then discussed and reformulated with input from over 60 multidisciplinary clinicians and researchers during a perinatal mental health and birth trauma research meeting in Europe. A revised definition was then shared with consumer groups in eight countries to confirm its face validity and adjusted based on their feedback. RESULTS The stepwise process confirmed that a woman-centered and inclusive definition was important. The final definition was: "A traumatic childbirth experience refers to a woman's experience of interactions and/or events directly related to childbirth that caused overwhelming distressing emotions and reactions; leading to short and/ or long-term negative impacts on a woman's health and wellbeing." CONCLUSIONS This definition of a traumatic childbirth experience was developed through consultations with experts and consumer groups. The definition acknowledges that low-quality provider interactions and obstetric violence can traumatize individuals during childbirth. The women-centered and inclusive focus could help women to identify and validate their experiences of traumatic birth, offering benefits for practice, education, and research, as well as for policymaking and activism in the fields of perinatal mental health and respectful maternity care.
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Affiliation(s)
- Julia Leinweber
- Institut of Midwifery, Charité-University Medicine Berlin, Berlin, Germany
| | - Yvonne Fontein-Kuipers
- School of Midwifery, Health and Social Work, University College Antwerp, Antwerp, Belgium.,Edinburgh Napier University, School of Health and Social Care, Edinburgh, Scotland
| | - Gill Thomson
- Maternal and Infant Nutrition & Nurture Unit, School of Community Health & Midwifery, University of Central Lancashire, Preston, UK
| | | | - Christina Nilsson
- Faculty of Caring Science, Work Life and Social Welfare, University in Borås, Borås, Sweden
| | | | - Ibone Olza
- European Institute of Perinatal Mental Health, Madrid, Spain
| | - Eleni Hadjigeorgiou
- Nursing Department, Faculty of Health Science, Cyprus University of Technology, Limassol, Cyprus
| | - Claire Stramrood
- Department of Obstetrics and Gynaecology, OLVG Hospital, Amsterdam, The Netherlands
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Leinweber J, Fontein-Kuipers Y, Karlsdottir SI, Ekström-Bergström A, Nilsson C, Stramrood C, Thomson G. Developing a woman-centered, inclusive definition of positive childbirth experiences: A discussion paper. Birth 2022; 50:362-383. [PMID: 35790019 DOI: 10.1111/birt.12666] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 12/01/2022]
Abstract
INTRODUCTION A positive childbirth experience promotes women's health, both during and beyond the perinatal period. Understanding what constitutes a positive childbirth experience is thus critical to providing high-quality maternity care. Currently, there is no clear, inclusive, woman-centered definition of a positive childbirth experience to guide practice, education, and research. AIM To formulate an inclusive woman-centered definition of a positive childbirth experience. METHODS A six-step process was undertaken: (a) Key concepts associated with a positive childbirth were derived from a rapid literature review; (b) The key concepts were used by interdisciplinary experts in the author group to create a draft definition; (c) The draft definition was presented to clinicians and researchers during a European research meeting on perinatal mental health; (d) The authors integrated the expert feedback to refine the working definition; (e) A revised definition was shared with women from consumer groups in six countries to confirm its face validity; and (f) A final definition was formulated based on the women's feedback (n = 42). RESULTS The following definition was formulated: "A positive childbirth experience refers to a woman's experience of interactions and events directly related to childbirth that made her feel supported, in control, safe, and respected; a positive childbirth can make women feel joy, confident, and/or accomplished and may have short and/or long-term positive impacts on a woman's psychosocial well-being." CONCLUSIONS This inclusive, woman-centered definition highlights the importance of provider interactions for facilitating a positive childbirth experience. Feeling supported and having a sense of control, safety, and respect are central tenets. This definition could help to identify and validate positive childbirth experience(s), and to inform practice, education, research, advocacy, and policy-making.
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Affiliation(s)
- Julia Leinweber
- Institute of Midwifery, Charité-University Medicine Berlin, Berlin, Germany
| | - Yvonne Fontein-Kuipers
- School of Midwifery, Health and Social Work, University College Antwerp, Antwerp, Belgium.,Edinburgh Napier University, School of Health and Social Care, Edinburgh, UK
| | | | - Anette Ekström-Bergström
- Department of Health Sciences, University West, Trollhättan, Sweden.,Department of Nursing and Reproductive, Perinatal and Sexual Health, School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Christina Nilsson
- Munkebäck Antenatal Clinic, Region Västra Götaland, Gothenburg, Sweden
| | - Claire Stramrood
- Department of Obstetrics and Gynaecology, OLVG Hospital, Amsterdam, The Netherlands
| | - Gill Thomson
- Maternal and Infant Nutrition & Nurture Unit, School of Community Health & Midwifery, University of Central Lancashire, Preston, UK
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Middleton N, Kolokotroni O, Christodoulides V, Hadjigeorgiou E, Gourounti C, Leinweber J, Gouni O, Lykeridou K, Sarantaki A, Karanikola M, Nicolaou C, Kouta C, Bachetta B, Papain S, Pedersen E, Baum A. 117A digital resource for enhancing parental health literacy during the transition to parenthood. Int J Epidemiol 2021. [DOI: 10.1093/ije/dyab168.438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
While the transition to parenthood is critical for mother-child health, traditional antenatal education has been questioned. Digital resources provide opportunities for reducing social disparities and enhancing health literacy, particularly important in a medicalized and decentralized birth environment with high caesarean and low breastfeed rates.
Methods
Within a Participatory Action Research (PAR) framework, formative qualitative and quantitative methods were employed to assess the cross-national transferability of Baby Buddy (UK), and deliver a locally relevant resource to inform, enhance user-provider communications and support shared decision-making.
Results
Using consensus-building and priority-setting techniques, we engaged with the local health professional community and parents-to-be to assess available resources, identify gaps and priorities in an eDelphi survey (N = 275 mums, 193 professionals) and gain an in-depth understanding on information-seeking behaviours and participation in decision-making in a series of focus groups with antenatal educators (N = 20) and new mums/ mums-to-be (N = 62). New material was co-created with participants and an intervention for embedding the tool in clinical practice was proposed within the COM-B behavioural change framework.
Conclusions
The project is a “proof of concept” for exchange of innovation and a “complimentary” model of maternal healthcare delivery. Beyond a learning experience for the participants, the use of PAR provided ground for building transdisciplinary alliances.
Key messages
Other than enhancing health literacy, digital resources can support the educational role of health professionals
PAR provides a framework to engage with the community, building a sense of common purpose
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Affiliation(s)
- Nicos Middleton
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Ourania Kolokotroni
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
- Birth Forward, Non-Governmental Organization, Nicosia, Cyprus
| | | | - Eleni Hadjigeorgiou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Claire Gourounti
- Department of Midwifery, University of West Attica, Athens, Greece
| | - Julia Leinweber
- Department of Midwifery, Evangelische Hochschule Berlin, Berlin, Germany
| | | | | | | | - Maria Karanikola
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Christiana Nicolaou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Christiana Kouta
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Britta Bachetta
- Department of Midwifery, Evangelische Hochschule Berlin, Berlin, Germany
| | | | - Eline Pedersen
- Birth Forward, Non-Governmental Organization, Nicosia, Cyprus
| | - Alison Baum
- Best Beginnings, Charity, London, United Kingdom
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Stahn D, Leinweber J. [Does Bed-Sharing Increase the Risk for Sudden Infant Death Syndrome? - A Review of the Literature and Official Guidelines of Selected EU Countries]. Z Geburtshilfe Neonatol 2021; 225:397-405. [PMID: 33752248 DOI: 10.1055/a-1392-1324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION In Europe in 2015, 726 infants died of sudden infant death syndrome (SIDS). Bed-sharing is often discussed as a risk factor for SIDS. This paper examines the evidence on the impact of bed-sharing on the risk of SIDS and considers the official recommendations of individual EU countries on safe infant sleep. METHOD An integrative literature review was conducted. The Cochrane Library, Pubmed, CINAHL, and MIDRIS databases were searched using the keywords "Sudden Infant Death Syndrome", "SIDS", bed sharing", "breastfeeding" and "baby sleep" for articles in the German or English language that were published between 2012 and February 2019. In a second step, official recommendations for safe baby sleep from 6 EU countries were analyzed. RESULTS The risk for SIDS in bed-sharing three months postpartum is not higher in the absence of risk factors. Not all EU country recommendations on bed-sharing and SIDS differentiate between bed-sharing in the first 3 months of the baby's life and bed-sharing with babies 3 months or older. CONCLUSION Parents and health care professionals need evidence-based information to optimize the newborn baby's sleeping environment. Official recommendations on safe baby sleep should be assessed in regards to their congruence with current research findings on bed-sharing and SIDS.
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Affiliation(s)
- Dörthe Stahn
- Evangelische Hochschule Berlin, Midwifery, Berlin, Deutschland
| | - Julia Leinweber
- Evangelische Hochschule Berlin, Midwifery, Berlin, Deutschland
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Leinweber J, Creedy DK, Rowe H, Gamble J. A socioecological model of posttraumatic stress among Australian midwives. Midwifery 2016; 45:7-13. [PMID: 27960122 DOI: 10.1016/j.midw.2016.12.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 09/02/2016] [Accepted: 12/02/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE to develop a comprehensive model of personal, trauma event-related and workplace-related risk factors for posttraumatic stress subsequent to witnessing birth trauma among Australian midwives. DESIGN a descriptive, cross-sectional design was used. PARTICIPANTS members of the Australian College of Midwives were invited to complete an online survey. MEASUREMENTS the survey included items about witnessing a traumatic birth event and previous experiences of life trauma. Trauma symptoms were assessed with the Posttraumatic Stress Disorder Symptom Scale Self-Report measure. Empathy was assessed with the Interpersonal Reactivity Index. Decision authority and psychological demand in the workplace were measured with the Job Content Questionnaire. Variables that showed a significant univariate association with probable posttraumatic stress disorder were entered into a multivariate logistic regression model. FINDINGS 601 completed survey responses were analysed. The multivariable model was statistically significant and explained 27.7% (Nagelkerke R square) of the variance in posttraumatic stress symptoms and correctly classified 84.1% of cases. Odds ratios indicated that intention to leave the profession, a peritraumatic reaction of horror, peritraumatic feelings of guilt, and a personal traumatic birth experience were strongly associated with probable Posttraumatic Stress Disorder. CONCLUSIONS risk factors for posttraumatic stress following professional exposure to traumatic birth events among midwives are complex and multi-factorial. Posttraumatic stress may contribute to attrition in midwifery. Trauma-informed care and practice may reduce the incidence of traumatic births and subsequent posttraumatic stress reactions in women and midwives providing care.
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Affiliation(s)
- Julia Leinweber
- Protestant University of Applied Sciences Berlin, Teltower Damm 118, 14167 Berlin, Germany.
| | - Debra K Creedy
- Menzies Health Institute Queensland, Griffith University, Logan campus, University Drive, Meadowbrook, QLD 4131 Brisbane, Queensland, Australia.
| | - Heather Rowe
- School of Public Health and Preventive Medicine, Monash University, The Alfred Campus, Level 1 549 St Kilda Road Melbourne, VIC 3004 Melbourne, Victoria, Australia.
| | - Jenny Gamble
- Menzies Health Institute Queensland, Griffith University, Logan campus, University Drive, Meadowbrook, QLD 4131 Brisbane, Queensland, Australia.
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Leinweber J, Creedy DK, Rowe H, Gamble J. Responses to birth trauma and prevalence of posttraumatic stress among Australian midwives. Women Birth 2016; 30:40-45. [PMID: 27425165 DOI: 10.1016/j.wombi.2016.06.006] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 06/15/2016] [Accepted: 06/24/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Midwives frequently witness traumatic birth events. Little is known about responses to birth trauma and prevalence of posttraumatic stress among Australian midwives. AIM To assess exposure to different types of birth trauma, peritraumatic reactions and prevalence of posttraumatic stress. METHODS Members of the Australian College of Midwives completed an online survey. A standardised measure assessed posttraumatic stress symptoms. FINDINGS More than two-thirds of midwives (67.2%) reported having witnessed a traumatic birth event that included interpersonal care-related trauma features. Midwives recalled strong emotions during or shortly after witnessing the traumatic birth event, such as feelings of horror (74.8%) and guilt (65.3%) about what happened to the woman. Midwives who witnessed birth trauma that included care-related features were significantly more likely to recall peritraumatic distress including feelings of horror (OR=3.89, 95% CI [2.71, 5.59]) and guilt (OR=1.90, 95% CI [1.36, 2.65]) than midwives who witnessed non-interpersonal birth trauma. 17% of midwives met criteria for probable posttraumatic stress disorder (95% CI [14.2, 20.0]). Witnessing abusive care was associated with more severe posttraumatic stress than other types of trauma. DISCUSSION Witnessing care-related birth trauma was common. Midwives experience strong emotional reactions in response to witnessing birth trauma, in particular, care-related birth trauma. Almost one-fifth of midwives met criteria for probable posttraumatic stress disorder. CONCLUSION Midwives carry a high psychological burden related to witnessing birth trauma. Posttraumatic stress should be acknowledged as an occupational stress for midwives. The incidence of traumatic birth events experienced by women and witnessed by midwives needs to be reduced.
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Affiliation(s)
- Julia Leinweber
- Menzies Health Institute Queensland, Griffith University, Logan Campus, University Drive, Meadowbrook, QLD 4131, Australia.
| | - Debra K Creedy
- Menzies Health Institute Queensland, Griffith University, Logan Campus, University Drive, Meadowbrook, QLD 4131, Australia.
| | - Heather Rowe
- School of Public Health and Preventive Medicine, Monash University, The Alfred Campus, Level 1 549 St Kilda Road, Melbourne, VIC 3004, Australia.
| | - Jenny Gamble
- Menzies Health Institute Queensland, Griffith University, Logan Campus, University Drive, Meadowbrook, QLD 4131, Australia.
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Leinweber J, Rowe HJ. The costs of 'being with the woman': secondary traumatic stress in midwifery. Midwifery 2008; 26:76-87. [PMID: 18562056 DOI: 10.1016/j.midw.2008.04.003] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2008] [Revised: 04/05/2008] [Accepted: 04/13/2008] [Indexed: 11/19/2022]
Abstract
OBJECTIVE it is widely acknowledged that caring can cause emotional suffering in health-care professionals. The concepts of compassion fatigue, post-traumatic stress disorder and secondary traumatic stress are used to describe the potential consequences of caring for people who are or have experienced trauma. Empathy between the professional and patient or client is a key feature in the development of secondary traumatic stress. The aim of this paper is to contribute to the conceptual development of theory about dynamics in the midwife-woman relationship in the context of traumatic birth events, and to stimulate debate and research into the potential for traumatic stress in midwives who provide care in and through relationships with women. METHOD the relevant literature addressing secondary traumatic stress in health-care professionals was reviewed. FINDINGS it is argued that the high degree of empathic identification which characterises the midwife-woman relationship in midwifery practice places midwives at risk of experiencing secondary traumatic stress when caring for women experiencing traumatic birth. It is suggested that this has harmful consequences for midwives' own mental health and for their capacity to provide care in their relationships with women, threatening the distinct nature of midwifery care. CONCLUSIONS opportunities for research to establish the existence of this phenomenon, and the potential implications for midwifery practice are identified.
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Affiliation(s)
- Julia Leinweber
- Key Centre for Women's Health in Society, School of Population Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Vic. 3010, Australia.
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