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Synthesis of Mixed Research on Posttraumatic Stress Related to Traumatic Birth

Published:April 05, 2019DOI:https://doi.org/10.1016/j.jogn.2019.02.004

      Abstract

      Objective

      To synthesize mixed-research results (quantitative and qualitative) on posttraumatic stress in women who experienced traumatic births.

      Data Sources

      PubMed, Scopus, and PsycINFO databases.

      Study Selection

      Quantitative and qualitative studies were included if they were published in English from January 1, 2009, through December 31, 2018, and focused on posttraumatic stress in the postpartum period related to traumatic childbirth.

      Data Extraction

      The final sample consisted of 59 studies: 4 qualitative and 55 quantitative. Both authors independently appraised each study using the Critical Appraisal Skills Programme. Quantitative studies were synthesized by narrative synthesis and vote counting, and qualitative studies were synthesized by content analysis.

      Data Synthesis

      In the included studies, prevalence rates of elevated posttraumatic stress ranged from 0.8% to 26%. Significant predictors of posttraumatic stress that occurred before childbirth and those that were birth related were identified. Reports of six intervention studies to decrease posttraumatic stress symptoms after traumatic births were included. These interventions focused on postnatal debriefing, expressive writing, online cognitive behavioral therapy, a brief cognitive intervention, and the implementation of the nine instinctive stages of the infant during the first hour after birth. We created four themes from the findings of the qualitative studies: Distressing Symptoms, Detrimental Effect of Posttraumatic Stress on Women’s Relationships With Their Infants and Partners, Critical Influence of Support, and Debriefing.

      Conclusion

      When a woman experiences posttraumatic stress related to a traumatic birth, the entire family unit is vulnerable. Findings from quantitative predictor studies can be used to develop an instrument to screen women for risk factors for posttraumatic stress related to birth trauma. Primary interventions are needed to prevent women from experiencing traumatic births.

      Keywords

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      Biography

      Cheryl Tatano Beck, DNSc, CNM, FAAN, is a distinguished professor in the School of Nursing, University of Connecticut, Storrs, CT.

      Biography

      Sharon Casavant, MS, RN, is a research assistant in the School of Nursing, University of Connecticut, Storrs, CT.