Women's experiences of trauma-informed care in midwifery and maternity services and implications for maternal wellbeing: A qualitative systematic review.

Abstract

Introduction: Trauma-informed care has been increasingly advocated within maternity services as an approach to promote safety, autonomy, and respectful care. However, qualitative evidence exploring how participants experienced trauma-informed care across maternity and midwifery services has not been systematically synthesized. This review therefore aimed to synthesize qualitative evidence on women's experiences of trauma-informed care across maternity services, including midwifery care, during pregnancy, childbirth, and the postpartum period.

Methods: A systematic review was conducted in accordance with PRISMA 2020 and ENTREQ guidelines. Five electronic databases (PubMed, Scopus, Web of Science, CINAHL, and PsycINFO) were searched for peer-reviewed qualitative studies published in English. Eligible studies explored women's experiences of trauma-informed, trauma-sensitive, or related care practices within maternity settings. Data were synthesized using thematic synthesis, and methodological quality was appraised using the CASP qualitative checklist.

Results: Fifteen qualitative studies were included. Four analytical themes were identified: 1) creating safety and preventing re-traumatization; 2) respectful communication and informed consent; 3) emotional validation, trust, and relational attunement; and 4) power, control, and women's agency in maternity care. Across studies, trauma-informed care was experienced not as a discrete intervention but as a relational approach embedded in everyday maternity practices.

Conclusions: Women's experiences suggest that trauma-informed principles may contribute to positive care experiences and support psychological safety, autonomy, and relational wellbeing across the perinatal period, when embedded within routine midwifery and maternity practice.