Catastrophic thinking: Is it the legacy of traumatic births? Midwives’ experiences of shoulder dystocia complicated births

The impact on midwives and their practice after caring for women who have a traumatic childbirth: A systematic review

“…Eight studies utilized qualitative approaches, 20,23,25,27,28,45,46,49 with a descriptive mode of inquiry. Seven qualitative studies collected data through interviews.…”

“…When there was contact with a senior colleague, midwives felt that the focus was to determine what went wrong rather than to support them 20 . Study participants highlighted that even if the outcome of a birth was favorable, it could still be traumatizing 27 …”

“…Permission to take time off was also considered to be beneficial 34 . Continuity of care increased the coping capabilities of midwives 27,28 …”

“…20,25 After the realization of an unexpected event, midwives spoke about high levels of fear and anxiety, 27,47 as they desperately attempted to manage the situation and prevent adverse outcomes. 27 Midwives felt scared and guilty due to the potential negative physical and emotional influence a traumatic childbirth could have on the families. When an adverse outcome occurred, midwives were overcome by deep sadness and felt they had "let the woman down."…”

“…Hypervigilance and prophylactic intervention (routine episiotomy and oxygen initiation immediately after birth) were common alterations to midwives' practice, to prevent the recurrence of a traumatic experience and/ or to protect themselves and women. 20,22,23,27,46 Midwives also feared litigation which exacerbated their defensive practice. 22,23,32 With a heightened sense of fear and stress, every birth became a potentially traumatic event.…”