Background Many women experience their childbirth as traumatic, and 4-6% of mothers present with postnatal post-traumatic stress disorder. Aims To measure the relationship between obstetric intervention, perceived support in childbirth and mothers' experiences of postnatal trauma, and to identify salient aspects of the birth experience that are considered traumatic. Methods A total of 222 women in their first year postpartum were recruited between October and December 2018 via local mother and baby groups in southwest England (UK) and online social media pages. They completed an online survey regarding their birth experience. Further insight into mother's birth experiences was garnered through free-text responses in the survey. Results Overall, 29% of mothers experienced a traumatic birth and 15% met full or partial criteria for post-traumatic stress disorder. Feeling supported mediated the relationship between obstetric intervention and postnatal trauma symptoms. Conclusions This study reinforces the value of supportive healthcare professionals and the power of a nurturing environment, which can buffer the potentially negative effects of an obstetrically complicated birth on postnatal trauma symptoms.

Background Approximately one-third of women reflect on childbirth as a traumatic experience and the way women appraise their birth experience is significant to their postnatal wellbeing. This study aimed to identify and compare experiences of childbirth for mothers who reflect on birth as a traumatic or non-traumatic event. Methods Semi-structured interviews were conducted with 14 mothers in the postpartum period who appraised their birth as either traumatic or non-traumatic. The data were analysed using thematic analysis to elicit themes and subthemes. Results Thematic analysis revealed two contrasting themes relating to whether women felt empowered or powerless during birth. Empowerment was associated with women's trust in their maternity care, the sense of control they felt over their body and birth and the extent to which they felt informed of their options. Being powerless was associated with distrust towards healthcare services, feeling as though they lacked control over the process and feeling ‘in the dark’ about what was happening. Conclusions Women's sense of empowerment during birth is an important contributor to the appraisal of childbirth as a traumatic or non-traumatic experience. Empowerment is largely determined by the dynamic between a mother and the support around her.

Due to the unpredictable nature of traumatic events, prospective research into trauma relies upon laboratory methods utilising distressing film scenes to act as a trauma analogue measuring vulnerability factors and testing interventions applied to posttraumatic stress disorder (PTSD). This is the first study to test whether Virtual Reality (VR) provides a more effective trauma analogue than traditional on-screen presentation by direct comparison of the same real-life trauma film. Participants viewed footage of a staged car accident either presented in VR (N = 31) or on-screen (OS) (N = 30). Both groups recorded sense of presence, pre- and post-film mood and state anxiety. After the film, some participants (VR: n = 18; OS: n = 12) reported involuntary intrusions of the film and recorded the emotionality of these. VR presentation evoked a greater sense of presence, yet both VR and OS presentation elicited negative mood and involuntary intrusions. Although intrusions were more vivid in the VR condition, there were no significant differences in frequency or distress. However, a greater sense of presence, regardless of medium, was predictive of increased emotional reaction to the film and greater intrusion frequency and distress. Therefore, implementing a VR paradigm could be directly beneficial for TFP research concerning sense of presence or vividness of intrusions. The association between enhanced sense of presence and stress response suggests that an effective trauma analogue should be immersive, and VR presentation is a useful medium to elicit a greater sense of immersion.

Background Breastfeeding rates at 6 months in the UK have remained low in recent years, highlighting a need to better understand the factors that influence breastfeeding behaviour. Aim To investigate factors that influence breastfeeding behaviour in the UK and to understand the role of health professionals in promoting and facilitating breastfeeding. Methods Participants with breastfeeding experience (n=1505) completed an online survey, with 30 agreeing to be interviewed. Survey data were analysed using quantitative content analysis and a mixed thematic approach was employed to analyse interview data. Themes were derived from triangulation of survey and interview data. Results The survey identified a range of feeding complications. Thematic analysis identified four themes related to factors influencing breastfeeding: attitudes, availability of information, birthing experience and maternal mental health. Conclusions Healthcare professionals play an important role in the decision to breastfeed. It is essential that appropriate support and information is made available from early in pregnancy and throughout the breastfeeding journey. Particular support and advice is needed for those who have experienced traumatic births or are struggling with poor mental health.

One in five women in the UK develop mental health problems during pregnancy or in the first year after childbirth. ‘Birth trauma’ is a common birth-related mental health issue which stems from perceiving childbirth as a traumatic experience; the term ‘birth trauma’ also encompasses living with and experiencing the accompanying symptoms of trauma after childbirth. A mini focus group study was conducted with two experienced perinatal counsellors to discuss their experiences working with parents struggling with birth trauma. Analysis of the focus group revealed five key themes: the complexity of birth trauma; the power of communication; changes in culture; falling through the gaps and coping with trauma. The themes identified reflect previous academic research on parent and clinician experiences of birth trauma as well as national reports aimed at improving maternity care for parents.