BackgroundA negative experience in childbirth is associated with chronic maternal morbidities. The aim of this systematic review and meta-analysis was to identify currently available successful interventions to create a positive perception of childbirth experience which can prevent psychological birth trauma.MethodsRandomized controlled trials of interventions in pregnancy or labour which aimed to improve childbirth experience versus usual care were identified from 1994 to September 2016. Low risk pregnant or childbearing women were chosen as the study population. PEDRO scale and Cochrane risk of bias tool were used for quality assessment. Pooled effect estimates were calculated when more than two studies had similar intervention. If it was not possible to include a study in the meta-analysis, its data were summarized narratively.ResultsAfter screening of 7832 titles/abstracts, 20 trials including 22,800 participants from 12 countries were included. Successful strategies to create a positive perception of childbirth experience were supporting women during birth (Risk Ratio = 1.35, 95% Confidence Interval: 1.07 to 1.71), intrapartum care with minimal intervention (Risk Ratio = 1.29, 95% Confidence Interval:1.15 to 1.45) and birth preparedness and readiness for complications (Mean Difference = 3.27, 95% Confidence Interval: 0.66 to 5.88). Most of the relaxation and pain relief strategies were not successful to create a positive birth experience (Mean Difference = − 2.64, 95% Confidence Intervention: − 6.80 to 1.52).ConclusionThe most effective strategies to create a positive birth experience are supporting women during birth, intrapartum care with minimal intervention and birth preparedness. This study might be helpful in clinical approaches and designing future studies about prevention of the negative and traumatic birth experiences.Electronic supplementary materialThe online version of this article (10.1186/s12978-018-0511-x) contains supplementary material, which is available to authorized users.

BackgroundPsychologically traumatic events can affect anybody, but consequences of psychological birth trauma for the mother are very profound, extensive and unforgettable. Furthermore, the mother’s response not only touches the mother, but also affects the child, the father and the society. The objective of this study was to explore the mothers’ response to psychological birth trauma.ObjectivesPsychological birth trauma is a complex matter as the length of a women`s life and mother`s responds can be present through different psychological and physical ways. In this regard, the mothers suffer from its consequences, but they do not know what is going on? Mothers are getting worse every day by “the silent effects of the psychological phenomena”.Materials & MethodsThis qualitative study was conducted on 23 mothers with psychological birth trauma experience, who were recruited from health centers of the capital and one of the metropolises of Iran. Their interviews were transcribed verbatim and analyzed by the content analysis method.ResultsThree themes were extracted from the data: impact on health, changes in mother`s roles, and changes decision making ability. Several categories and sub-categories also emerged from the data (physical and psychological problems, bonding with the child, relationship with husband, social role, cesarean request and psychological inability to have another child).ConclusionsBy considering the mothers` responses to traumatic labor, which endangers the health of the child as well as that of the mother and impairs their familial and social relationships, midwives should notice the consequences of psychological birth trauma in order to plan supportive and timely interventions.

IntroductionIntimate partner violence (IPV) in pregnancy is considered as an additional threat to the maternal/fetal health. The present study was aimed to investigate the effectiveness of training problem-solving skills on IPV against pregnant women.MethodsThe present randomized clinical trial was conducted on 125 and 132 women visiting the health centers of Tehran as the intervention and the control groups, respectively; samples were selected using random stratified cluster sampling. The intervention group underwent four problem-solving training sessions. Three months later, both groups completed the revised Conflict Tactics Scale questionnaire. Data were analyzed using SPSS v.16.ResultsThe mean (SD) ages of the participants were 27.51 (4.26) and 27.02 (4.26) years, respectively, in the control and the intervention groups. The rates of the physical and psychological violence were significantly reduced after the intervention in the intervention group. Risk differences of the physical, psychological and sexual violence before and after the intervention were 3% (95% CI: -8.23 to14.13, P = 0.6), 1.5% (95% CI: -4.93 to 8.03, P = 0.6) and 4.8% (95% CI: -7.11 to 16.52, P = 0.4) in the control group and 8.8% (95% CI: -3.47 to 20.71, P = 0.1), 25.4% (95% CI: 15.77 to 34.66, P < 0.001) and 4.9% (95% CI: -7.38 to16.97, P = 0.4) in the intervention group, respectively.ConclusionIt seems that training this skill as a part of the routine prenatal care could be effective in reducing intimate partner violence.

Childbirth is a unique experience in women's life. Various factors including human and non-human environment are involved in shaping the experience of childbirth.This study investigated the role of the environment on the psychological birth trauma from the perceptions of Iranian mothers. A qualitative descriptive study was conducted from September 2011 to February 2012, using audiotaped interviews with 23 Iranian women recruited from Tehran and Isfahan. The interviews were transcribed verbatim and analysed using the content analysis. Two themes were extracted from the data: human and non-human environment; and several categories also emerged from the data, which are communication with mother, awareness of mother's needs, support for mother, medical clinical competence, professional responsibility, hospital's physical structure, hospital's equipment, routine care in hospital and rules governing the hospital's environment, respectively. Considering the significant role of environment in psychological birth trauma of the mother, an appropriate intervention must be developed to enhance both human and non-human environment in order to reduce the psychological birth trauma.