Empowered or powerless? Contributing factors to women's appraisal of traumatic childbirth

Abstract

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.

Breastfeeding experiences and support: identifying factors influencing breastfeeding behaviour

“…The findings from this study clearly identified that support, particularly around aspects of mental health are still lacking within antenatal, perinatal and postnatal services in the UK, as identified by previous studies (Baptie et al, 2021). Participants talked of experiences of poor mental health that were either left untreated or not addressed appropriately until long after they had been reported.…”

“…Poor mental health is known to be a contributing factor in early cessation of breastfeeding (Silva et al, 2017) and it is vital that there are appropriate support structures in place to ensure women receive the help they need. This is particularly important for women who experienced a traumatic birth who may be more susceptible to experience mental health issues postpartum (Baptie et al, 2021). Previous literature has identified that mothers who had experienced a traumatic birth felt it vital to be able to initiate breastfeeding to regain the sense of control lost during the birthing process (Baptie et al, 2021).…”

“…This is particularly important for women who experienced a traumatic birth who may be more susceptible to experience mental health issues postpartum (Baptie et al, 2021). Previous literature has identified that mothers who had experienced a traumatic birth felt it vital to be able to initiate breastfeeding to regain the sense of control lost during the birthing process (Baptie et al, 2021). The current findings support this and while a positive breastfeeding experience can overcome the psychological impact of a traumatic birth, for those who are then unable to breastfeed, the consequences for their ongoing mental health may be particularly negative.…”

The bidirectional relationship between breastfeeding and mental health

“…Feelings of distress or disappointment about the delivery, anxiety about the baby, and perceived inability to cope are among many negative feelings post-delivery (O'Hara & Wisner, 2014). While for many these reactions are likely to be short-lived and transient, an important complication of pregnancy and childbirth is perinatal mental illness, with childbirth associated with the onset of depressive and anxiety disorders (O'Hara & Wisner, 2014;Keevash et al, 2018;Norman et al, 2022) and trauma-related symptoms (Baptie et al, 2021). While perinatal mental health difficulties occur in a small subset of individuals, they can cause extreme distress to the mother and her family, as well as costing an estimated cost of £8.1 billion each year to society in the UK (Bauer et al, 2014).…”

“…Of this cost, only 28% relate to mother, with 72% relating to adverse impacts on the child (e.g. long-term physical and mental illness, reduced quality of life and reduced career prospects over a lifetime).Women experiencing perinatal mental health difficulties should have access to specialist advice, clear referral and management protocols in accordance with NICE guidelines (NICE, 2014), however service provision in the UK remains inadequate (Bauer et al 2014;Baptie et al, 2021;Norman et al, 2022).…”