Multigravidas' perceptions of traumatic childbirth: Its relation to some factors, the effect of previous type of birth and experience

Abstract

To investigate the relationship between multigravidas' perceptions of traumatic childbirth (PTC) and their socio-demographic characteristics and the effect of their previous types of birth and experiences on PTC. This descriptive study was conducted in a state hospital in Northern Turkey. The universe of the study consisted of multigravidas. The sample of the study comprised 161 pregnant women determined with G power analysis. The data were collected using the "Pregnant Introductory Information Form" and "Perception of Traumatic Childbirth Scale". The age, gestational week and the number of pregnancy of the participants were 28.27 ± 5.13, 30.45 ± 7.71 and 1.94 ± 1.07 respectively. The average PTC score was 70.57 ± 21.89. 1.9%, 28.6%i 39.1% and 23.6% of the pregnant women perceived their birth as "very low", "low", "moderate" and as "high" traumatic respectively. There was a negative correlation between the average PTC score and the gestational age, the number of pregnancies and the duration of the adverse events and positive correlation between the average PTC score and the number of hospital visits during pregnancy (p <0.05). Compared with those who had cesarean section and no intervention, PTC score was higher in those who had a previous vaginal delivery and interventions. The average PTC score of those planning to give vaginal delivery was higher than those planning cesarean birth (p <0.05). The women who had a chronic disease before pregnancy (p<0.05) and those who had a vaginal birth with only a midwife and were satisfied with her communication had lower PTC scores (p> 0.05). Six out of every 10 pregnant women perceived their delivery traumatic at a moderate / high level. PTC was higher in those having vaginal birth and an intervention previously and planning a vaginal birth again. The early identification of the risk of PTC before pregnancy or early pregnancy and taking precautions are recommended.

Midwives' experiences of traumatic births: A systematic review and meta-synthesis

“…If the midwives exposed to trauma are not treated, the mental health of the women that these midwives care for is at risk 4 , 11 , 23 . In a qualitative study, non-empathic behaviors, and some applications (such as fundal compression, episiotomy) of midwives 30 and the negative attitude and ability of midwifery in the previous birth of multigravidas in another study 31 were found to have an impact on negative birth experience and traumatic birth perception. However, the midwife’s empathic and emotional relationship with women can reduce the risk of trauma.…”

“…The legal process after birth trauma can further deteriorate the birth trauma of the midwife 24 , 31 . This study revealed that the midwife’s sadness due to the lawsuit filed against her or her collecting evidence against the possibility of a lawsuit was a further trauma for her.…”

“…Factors such as prolonged labor, severe perception of birth pain, interventions applied at birth (fundal pressure, episiotomy, etc. ), and negative communication of midwives during birth could lead women to perceive birth as traumatic 21 , 22 , 25 , 31 . Haung et al 26 determined in their study that prolonged labor, high severity of birth pain, and baby loss as the reasons for the traumatic perceptions of women from the midwives’ perspective.…”

Risk status and traumatic birth perception in pregnancy

“…in their previous vaginal deliveries were compared with women who did not undergo intervention during their deliveries, and traumatic birth perception levels were found to be higher in women who experienced interventional vaginal delivery compared to other women 3,8 . In another study, it was found that women who had a previous vaginal delivery with the help of a midwife and had high birth satisfaction levels were found to have low traumatic birth perception 9 . The results of the research show that the support of the midwife and her communication with pregnant women are very important in determining the traumatic perception of birth 10 .…”

The effect of empathy training given to midwives on the empathic communication skills of midwives and the birth satisfaction of mothers giving birth with the help of these midwives: A quasi‐experimental study

“…Several studies investigating the empathic skills of midwives and maternal satisfaction in birth experience suggest that midwives' communication scores are insufficient, 11‐13 the mothers are dissatisfied with their birth experience due to their midwives' negative attitudes and behaviours, 14‐16 and the level of vaginal birth satisfaction is low 9,11,17 . Mother‐friendly hospital practices 18 and childbirth preparation training 19 are some of the practices that aim to improve maternal satisfaction and perception of positive birth at birth.…”