Labor and Delivery Nurse Psychological Trauma: An Integrative Review.

Abstract

Background: This integrative review used Whittemore and Knafl's (2005) framework to critique the available quantitative evidence examining multiple types, prevalence, and impact of psychological trauma in labor and delivery nurses. This review synthesizes the quantitative evidence on multiple types of trauma in this population.

Methods: Inclusion criteria were quantitative and mixed-methods studies of labor and delivery nurses examining types of trauma as defined by Foli's Middle-Range Theory of Nurses' Psychological Trauma. Studies on patient trauma from nursing care were excluded. CINAHL, Scopus, Medline, PubMed, and Web of Science databases were searched for studies electronically available through April 8, 2024. The Joanna Briggs Institute critical appraisal tools facilitated quality and bias assessments. A conceptual model based on Foli's theory contextualizes the findings.

Results: Nine studies (five cross-sectional descriptive, one longitudinal, and three mixed-methods) are included in this review. Across all studies, unique aspects of the labor and birth nurse role were found to contribute to trauma, including exposure to perinatal death and fetal demise, high rates of patient trauma, an increasingly medicalized birth environment, and emotional burnout. Labor and birth nurses experienced psychosomatic symptoms, negative effects on their relationships and quality of life, and increased rates of attrition, although nurses also identified specific system supports to decrease these effects.

Discussion: Limited research exists on the types of and impact of trauma experienced by labor and delivery nurses. This integrative review aims to address this gap in knowledge, while also suggesting implications for future research and policy. There is emerging evidence that post-traumatic growth is possible in this population with system support, yet many nurses are unaware of or have inadequate access to such resources. More research is needed to fully understand the magnitude of this population's psychological trauma and provide effective support strategies.