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RESEARCH PAPER
Mode of delivery and traumatic birth experience – the role of the midwife. A qualitative pilot study
 
 
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National School of Public Health, Athens, Greece
 
 
Submission date: 2023-05-30
 
 
Acceptance date: 2023-05-30
 
 
Publication date: 2023-06-28
 
 
Corresponding author
Maria Kyrou   

National School of Public Health, 196 Alexandras Avenue, Athens, 115 21, Greece
 
 
ΕΛΕΥΘΩ 2023;22(2):7
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Labor and childbirth are highly emotional experiences and if perceived as acute stressors, they can become traumatic and lead to post-traumatic stress disorder. The traumatic nature of childbirth can also affect partner, who witnesses the distressing labor. A traumatic birth experience can give rise to various difficulties.Stress factors during labor can range from life-threatening situations to perceived threats, including loss of control, loss of dignity, negative environments, sense of fear, loss of control,terror.

Methods:
This study employed a pilot qualitative research design. Interviews were conducted using a questionnaire divided into three parts. The interviews were conducted between January 2018 and March 2018. Thirteen women who had given birth to their first child via cesarean section participated in the study. These women subsequently attempted to have a vaginal birth for their second child. All participants adhered to the criteria for attempting vaginal birth after cesarean, as outlined by the American College of Obstetricians and Gynecologists and the Royal College of Obstetricians and Gynecologists. All women completed the questionnaire.

Results:
The findings indicate that nearly half of the women experienced their first labor as a traumatic event. This traumatic birth experience led to difficulties with bonding, breastfeeding, and overall psychological well-being in the postpartum period. Additionally, the role of midwives was found to be crucial in shaping the birth experience.

Conclusions:
The study concludes that birth experiences can become traumatic when stress factors, such as loss of control, lack of respect, insufficient informed consent, hostile environments, and lack of support, are present. Regardless of the mode of delivery (cesarean, vaginal delivery, or assisted vaginal delivery), a positive birth experience is possible when women feel secure, trusted, supported, and involved in decision-making. Furthermore, the constant presence of midwives during labor appears to play a significant role in shaping both the birth experience and the postpartum period.

CONFLICT OF INTEREST
The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
 
REFERENCES (37)
1.
Afshar Y, Wang ET, Mei J, Esakoff TF, Pisarska MD, Gregory KD. Childbirth Education Class and Birth Plans Are Associated with a Vaginal Delivery. Birth. 2017;44(1):29-34. doi:10.1111/birt.12263
 
2.
Andrissi L, Petraglia F, Giuliani A, et al. The Influence of Doctor-Patient and Midwife-Patient Relationship in Quality Care Perception of Italian Pregnant Women: An Exploratory Study. PLoS One. 2015;10(4):e0124353. doi:10.1371/journal.pone.0124353
 
3.
Attanasio LB, Kozhimannil KB, Kjerulff KH. Women's preference for vaginal birth after a first delivery by cesarean. Birth. 2019;46(1):51-60. doi:10.1111/birt.12386
 
4.
Ayers S, Ford E. PTSD following childbirth. In: Martin CR, ed. Perinatal mental health: a clinical guide. M&K Update Ltd; 2012:155-164.
 
5.
Banerjee A, Sanyal D. Dynamics of doctor-patient relationship: A cross-sectional study on concordance, trust, and patient enablement. J Family Community Med. 2012;19(1):12-19. doi:10.4103/2230-8229.94006
 
6.
Brixval CS, Axelsen SF, Thygesen LC, Due P, Koushede V. Antenatal education in small classes may increase childbirth self-efficacy: Results from a Danish randomised trial. Sex Reprod Healthc. 2016;10:32-34. doi:10.1016/j.srhc.2016.03.003
 
7.
Chen HH, Lai JC, Hwang SJ, Huang N, Chou YJ, Chien LY. Understanding the relationship between cesarean birth and stress, anxiety, and depression after childbirth: A nationwide cohort study. Birth. 2017;44(4):369-376. doi:10.1111/birt.12295
 
8.
Chipidza FE, Wallwork RS, Stern TA. Impact of the Doctor-Patient Relationship. Prim Care Companion CNS Disord. 2015;17(5). doi:10.4088/PCC.15f01840
 
9.
Dahlberg U, Persen J, Skogås AK, Selboe ST, Torvik HM, Aune I. How can midwives promote a normal birth and a positive birth experience? The experience of first-time Norwegian mothers. Sex Reprod Healthc. 2016;7:2-7. doi:10.1016/j.srhc.2015.08.001
 
10.
Dunn EA, O'Herlihy C. Comparison of maternal satisfaction following vaginal delivery after caesarean section and caesarean section after previous vaginal delivery. Eur J Obstet Gynecol Reprod Biol. 2005;121(1):56-60. doi:10.1016/j.ejogrb.2004.11.010
 
11.
Forster DA, McLachlan HL, Davey MA, et al. Continuity of care by a primary midwife (caseload midwifery) increases women's satisfaction with antenatal, intrapartum and postpartum care: results from the COSMOS randomised controlled trial. BMC Pregnancy Childbirth. 2016;16:28. doi:10.1186/s12884-016-0798-y
 
12.
Garthus-Niegel S, von Soest T, Vollrath ME, Eberhard-Gran M. The impact of subjective birth experiences on post-traumatic stress symptoms: a longitudinal study. Arch Womens Ment Health. 2013;16(1):1-10. doi:10.1007/s00737-012-0301-3
 
13.
Garthus-Niegel S, von Soest T, Knoph C, Simonsen TB, Torgersen L, Eberhard-Gran M. The influence of women's preferences and actual mode of delivery on post-traumatic stress symptoms following childbirth: a population-based, longitudinal study. BMC Pregnancy Childbirth. 2014;14:191. doi:10.1186/1471-2393-14-191
 
14.
Hardy-Fairbanks AJ, Lauria MR, Mackenzie T, McCarthy M Jr. Intensity and unpleasantness of pain following vaginal and cesarean delivery: a prospective evaluation. Birth. 2013;40(2):125-133. doi:10.1111/birt.12039
 
15.
Homer CS, Besley K, Bell J, et al. Does continuity of care impact decision making in the next birth after a caesarean section (VBAC)? a randomised controlled trial. BMC Pregnancy Childbirth. 2013;13:140. doi:10.1186/1471-2393-13-140
 
16.
Homer CS, Leap N, Edwards N, Sandall J. Midwifery continuity of carer in an area of high socio-economic disadvantage in London: A retrospective analysis of Albany Midwifery Practice outcomes using routine data (1997-2009). Midwifery. 2017;48:1-10. doi:10.1016/j.midw.2017.02.009
 
17.
Hosseini Tabaghdehi M, Kolahdozan S, Keramat A, Shahhossein Z, Moosazadeh M, Motaghi Z. Prevalence and factors affecting the negative childbirth experiences: a systematic review. J Matern Fetal Neonatal Med. 2020;33(22):3849-3856. doi:10.1080/14767058.2019.1583740
 
18.
Kainu JP, Halmesmäki E, Korttila KT, Sarvela PJ. Persistent Pain After Cesarean Delivery and Vaginal Delivery: A Prospective Cohort Study. Anesth Analg. 2016;123(6):1535-1545. doi:10.1213/ANE.0000000000001619
 
19.
Keedle H, Schmied V, Burns E, Dahlen HG. The journey from pain to power: A meta-ethnography on women's experiences of vaginal birth after caesarean. Women Birth. 2018;31(1):69-79. doi:10.1016/j.wombi.2017.06.008
 
20.
Kohler S, Sidney Annerstedt K, Diwan V, et al. Postpartum quality of life in Indian women after vaginal birth and cesarean section: a pilot study using the EQ-5D-5L descriptive system. BMC Pregnancy Childbirth. 2018;18(1):427. doi:10.1186/s12884-018-2038-0
 
21.
Lewis M, Jones A, Hunter B. Women’s Experience of Trust Within the Midwife–Mother Relationship. Int J Childbirth. 2017;7(1):40-52. doi:10.1891/2156-5287.7.1.40
 
22.
Manoli E, Zisimou P. Risk factors for PTSD after Birth: Systematic Review. Technological University of Cyprus, 2016.
 
23.
McKellar L, Fleet J, Dove S. It's more than just luck: A qualitative exploration of breastfeeding in rural Australia. Women Birth. 2018;31(3):177-183. doi:10.1016/j.wombi.2017.09.005
 
24.
Modarres M, Afrasiabi S, Rahnama P, Montazeri A. Prevalence and risk factors of childbirth-related post-traumatic stress symptoms. BMC Pregnancy Childbirth. 2012;12:88. doi:10.1186/1471-2393-12-88
 
25.
Pereira TRC, Souza FG, Beleza ACS. Implications of pain in functional activities in immediate postpartum period according to the mode of delivery and parity: an observational study. Braz J Phys Ther. 2017;21(1):37-43. doi:10.1016/j.bjpt.2016.12.003
 
26.
Petrou S, Kim SW, McParland P, Boyle EM. Mode of Delivery and Long-Term Health-Related Quality-of-Life Outcomes: A Prospective Population-Based Study. Birth. 2017;44(2):110-119. doi:10.1111/birt.12268
 
27.
Razzaghi MR, Afshar L. A conceptual model of physician-patient relationships: a qualitative study. J Med Ethics Hist Med. 2016;9:14. Accessed May 20, 2023. https://www.ncbi.nlm.nih.gov/p...
 
28.
Renfrew MJ, McCormick FM, Wade A, Quinn B, Dowswell T. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database Syst Rev. 2012;5(5):CD001141. doi:10.1002/14651858.CD001141.pub4
 
29.
Romijn A, Muijtjens AMM, de Bruijne MC, et al. What is normal progress in the first stage of labour? A vignette study of similarities and differences between midwives and obstetricians. Midwifery. 2016;41:104-109. doi:10.1016/j.midw.2016.08.006
 
30.
Roostaee F, Tabatabaei SM, Zaboli M, et al. Breast-feeding Continuation in South-Eastern of Iran: the Associated Factors. Med Arch. 2015;69(2):98-102. doi:10.5455/medarh.2015.69.98-102
 
31.
Rowlands IJ, Redshaw M. Mode of birth and women's psychological and physical wellbeing in the postnatal period. BMC Pregnancy Childbirth. 2012;12:138. doi:10.1186/1471-2393-12-138
 
32.
Schmied V, Beake S, Sheehan A, McCourt C, Dykes F. Women's perceptions and experiences of breastfeeding support: a metasynthesis. Birth. 2011;38(1):49-60. doi:10.1111/j.1523-536X.2010.00446.x
 
33.
Schwab W, Marth C, Bergant AM. Post-traumatic Stress Disorder Post Partum: The Impact of Birth on the Prevalence of Post-traumatic Stress Disorder (PTSD) in Multiparous Women. Geburtshilfe Frauenheilkd. 2012;72(1):56-63. doi:10.1055/s-0031-1280408
 
34.
Shaban Z, Dolatian M, Shams J, Alavi-Majd H, Mahmoodi Z, Sajjadi H. Post-Traumatic Stress Disorder (PTSD) Following Childbirth: Prevalence and Contributing Factors. Iran Red Crescent Med J. 2013;15(3):177-182. doi:10.5812/ircmj.2312
 
35.
Shorten A, Shorten B. The importance of mode of birth after previous cesarean: success, satisfaction, and postnatal health. J Midwifery Womens Health. 2012;57(2):126-132. doi:10.1111/j.1542-2011.2011.00106.x
 
36.
Simpson M, Schmied V, Dickson C, Dahlen HG. Postnatal post-traumatic stress: An integrative review. Women Birth. 2018;31(5):367-379. doi:10.1016/j.wombi.2017.12.003
 
37.
Zhang T, Liu C. Comparison between continuing midwifery care and standard maternity care in vaginal birth after cesarean. Pak J Med Sci. 2016;32(3):711-714. doi:10.12669/pjms.323.9546
 
ISSN:1106-6822
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