Improving psychological and social support needs after traumatic birth: A qualitative study

Abstract

Introduction

Emergency deliveries increase maternal risk for postpartum depression (PPD) and post-traumatic stress disorder (PTSD). One in three women describe their birth experience as traumatic, but patient-centered support needs are unclear. We conducted a qualitative study of women with traumatic birth to identify patient-centered priorities to optimize mental health support.

Methods

Semi-structured interviews were conducted with women who experienced an emergency during birth, and who self-identified as experiencing traumatic birth. The Stanford Acute Stress Reaction Questionnaire and PTSD Checklist were completed. Interviews included open-ended questions about birth events that improved or worsened their delivery experience, perceptions of mental, physical, and emotional support provided by staff, and patient perspectives about psychological and social support referrals after emergent deliveries.

Results

A majority of participants met positive screening criteria for PTSD at the time of interviews. Birth experiences were affected by prenatal expectations, as well as the style and quality of clinical staff communication during and after delivery. There were four key themes central to their experiences and perceptions: (1) Emotional Impact and Intensity, (2) Factors Influencing Birth Experience, (3) Perceived Lack of Emotional Support, and (4) Desire for Post-Birth Follow-Up and Support. Participants almost unanimously desired to be offered psychosocial services after birth trauma.

Conclusion

There are significant gaps in emotional support and communication for patients experiencing traumatic births. Offering structured, in-hospital mental health referrals may address immediate psychological needs, aid in trauma recovery, and potentially mitigate long-term mental health consequences. These findings advocate for a more holistic approach to postpartum care that prioritizes both physical and emotional well-being.