„Hilflosigkeit, das Abgeben jeglicher Selbstverantwortung und
                    Selbstbestimmtheit“ – eine qualitative Auswertung von
                    traumatisierenden Geburtserlebnissen in Relation zum
                    Geburtsmodus

Hüner, Beate; Schmiedhofer, Martina; Polasik, A; Janni, Wolfgang; Reister, Frank; Lippke, Sonia

doi:10.1055/a-2039-3017

Cited by 4 publications

(3 citation statements)

References 46 publications

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“…These results are similar to the ndings in another study mentioned here in the introduction [12]. The study observed similar categories as in the present report.…”

Section: Discussion and Prognosissupporting

confidence: 94%

“…The sense of a lack of control along with a lack of selfe cacy were identi ed also in further studies as signi cant components of adverse or traumatizing birthing experiences [10,11]. To our knowledge, with regards to the German health care system only one study exists that analyzes reports of birthing experiences to establish a connection to the delivery mode [12]. The researchers came to the conclusion that an unplanned course of events during childbirth was more closely related to a higher risk of mental stress as well as feeling of guilt.…”

Section: Introductionmentioning

confidence: 99%

“…The conclusions of Bohren's categorization cannot be applied in detail to speci c situations of individual countries [6]. With regards to the health care system in Germany, there are to date very few studies that categorize adverse birth experiences [12,17]. In this study, 1) a system of categorization of adverse birth experiences was designed based on written birth reports, 2) the frequency of the identi ed categories was analyzed, and 3) contextualized with relation to the birth mode.…”

Section: Introductionmentioning

confidence: 99%

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Adverse Experiences during Childbirth – a mixed-methods study based on birth reports

Beck-Hiestermann,

Kücükokur-Bartel,

Gries

et al. 2024

Preprint

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Background: The birth of a child is a multifaceted event, and the mother’s perception of this event, whether positive or negative, is primarily influenced by the birthing environment, and above all, by the interaction with the healthcare staff attending the birth. Incidents of adverse experiences (AE) during childbirth can lead to further negative effects (e.g., a disrupted mother-child bond), though there has never been any uniform system of recording this data to date. Studies show that, among other things, the delivery mode can have an influence on the birthing experience. For the Germany health system, esp. in the field of obstetrics, very few qualitative studies have been conducted that use inductive categorization to analyze the women’s adverse experiences and further summarize them into categories of “adverse experiences” during childbirth. Aim: The goal of the present study is: 1) to establish a system of categorizing incidents of AE based on written birth reports; 2) to conduct a frequency analysis of the identified categories; and 3) establish a pattern of frequency related to the birth mode. Methods: The study was conducted as a mixed-methods study with a cross-sectional online survey. Along with the quantitative data, the experiences of the N = 445 women were analyzed by means of an unrestricted text field where participants could freely write their subjectively perceived AE and a qualitative content analysis. The identified, inductively designed categories were subjected to a frequency analysis and a chi-square test to determine the correlation frequency with the birth mode (sub-categorized into vaginal, operative vaginal, and primary and secondary cesarean). Results: Seven categories were identified: 1) adverse experience (AE) concerning autonomy (31.9 %); 2) AE caused by medical interventions or treatments (26.5 %); 3) AE as a result of care and support (19.3 %); 4) difficulty in communicating with the medical staff (16.6 %); 5) problems or AE affecting the exchange of information process between the women and the birth attendants (13.9 %); 6) structural conditions (7 %) and 7) other (unrelated to the medical staff) (26.1 %). The chi-square test showed there to be no significant correlation between the frequency of the individual categories and the birth mode. Conclusions: The study shows that women experience a broad spectrum of AEs during childbirth, with loss of autonomy being the most frequently cited. This underscores the importance of respect and the need to promote it. Nevertheless, it also raises questions about necessary restrictions in cases of fetal compromise. The study highlights the necessity of including women in the decision process, of a sufficient and easily comprehensible explanation of the information, as well as obtaining the patient’s consent in accordance with German law, as unauthorized medical intervention can also be perceived as an adverse experience. These identified categories provide a starting point for improving obstetric and psychological care.

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“…These results are similar to the ndings in another study mentioned here in the introduction [12]. The study observed similar categories as in the present report.…”

Section: Discussion and Prognosissupporting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Adverse Experiences during Childbirth – a mixed-methods study based on birth reports

Beck-Hiestermann,

Kücükokur-Bartel,

Gries

et al. 2024

Preprint

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Are 6 more accurate than 4? The influence of different modes of delivery on postpartum depression and PTSD

Beck-Hiestermann,

Hartung,

Richert

et al. 2024

BMC Pregnancy Childbirth

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Background Empirical evidence shows that 4.6–6.3% of all women develop a post-traumatic stress disorder (PTSD) and approximately 10–15% postpartum depression (PPD) following childbirth. This study explores the relationship between delivery mode and the occurrence of PTSD and PPD, specifically examining four distinct caesarean section (CS) modes: primary on maternal request (Grade 4), medically indicated primary (Grade 3), secondary CS from relative indication (Grade 2) and emergency secondary CS (Grade 1), compared to vaginal and assisted vaginal delivery (AVD). The research aims to understand how these six subcategories of delivery modes impact PPD and PTSD levels. Common predictors, including the need for psychological treatment before childbirth, fear of childbirth, planning of pregnancy, induction of labor, birth debriefing, and lack of social support after childbirth, will be analyzed to determine their association with postpartum mental health outcomes. Methods The study was planned and carried out by a research team of the psychology department at the Medical School Hamburg, Germany. Within an online-study (cross-sectional design) N = 1223 German speaking women with a baby who did not die before, during or after birth were surveyed once between four weeks and twelve months postpartum via an anonymous online questionnaire on demographic and gynecological data, delivery mode, PTSD (PCL-5) and PPD (EPDS). Results For both psychiatric disorders, ANOVA revealed significant differences between delivery mode and PPD and PTSD. With weak effects for PPD and medium to strong effects for PTSD. Post-hoc tests showed increased levels of PPD for two CS types (Grade 1, Grade 3) compared to vaginal delivery. For PTSD, secondary CS from relative indication (Grade 2), emergency secondary CS (Grade 1) and assisted vaginal delivery (AVD) were associated with elevated levels of PTSD. Regression analysis revealed delivery mode as a significant predictor of EPDS- (medium effect size) and PCL-5-Score (medium to high effect size). Limitation Delivery was considered as the potential traumatic event, and any previous traumas were not documented. Additionally, the categorization of delivery modes relied on subjective reports rather than medical confirmation. Conclusion The study highlights the influence of delivery mode on the mental health of postpartum mothers: different modes influence postpartum disorders in various ways. However, the definition of delivery mode was only stated subjectively and not medically confirmed. Further research should investigate which aspects of the different delivery modes affect maternal mental health and explore how the perception of childbirth may be influenced by specific delivery experiences.

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Are 6 more accurate than 4? The delivery mode and its influence on postpartum depression and PTSD.

Beck-Hiestermann,

Hartung,

Richert

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Empirical evidence shows that 2–6% of all women develop post-traumatic stress disorder (PTSD) and about 10–15% postpartum depression (PPD) after childbirth. This study examines PTSD and PPD in the context of delivery mode, focusing 4 different caesarean section modes, elective primary (Grade 4), medically indicated primary (Grade 3), secondary from relative indication (Grade 2) and emergency secondary caesarean section (Grade 1), compared to vaginal and assisted vaginal delivery (AVD). The impact of the six subdivided delivery mode categories on the level of postpartum depression and PTSD will be investigated using common predictors (for postpartum depression psychological treatment before childbirth, Fear of childbirth, Planning of pregnancy, social support after childbirth and for PTSD psychological treatment before childbirth, fear of childbirth, induction of labor, birth debriefing and social support after childbirth). Methods Between four weeks and two years postpartum, 1223 women were surveyed once via an anonymous online questionnaire on demographic and gynecological data, type of delivery, PTSD (PCL-5) and PPD (EPDS). Results For both psychiatric disorders, ANOVA revealed significant differences between delivery mode and PPD and PTSD. With weak effects for PPD and medium to strong effects for PTSD. Post-hoc tests showed increased levels of postpartum depression for all caesarean section types compared to both vaginal delivery types. For PTSD, secondary relative indication (Grade 2), emergency secondary caesarean section (Grade 1) and assisted vaginal delivery (AVD) were associated with elevated levels of PTSD. Regression analysis revealed the delivery mode as a significant predictor of EPDS- (medium effect size) and PCL-5-Score (medium to high effect size). Limitation: Delivery was assumed to be the traumatic event; previous traumas were not recorded. The definition of the delivery mode was reported subjectively and not medically confirmed. Conclusion The study highlights the influence of delivery modes on the mental health of postpartum mothers: different modes influence different postpartum disorders in different ways. However, the definition of the delivery mode was only stated subjectively and not medically confirmed. Further research should investigate which aspects of the different delivery modes influence maternal mental health and how the perception of the birth may depend on a specific delivery mode.

show abstract

„Hilflosigkeit, das Abgeben jeglicher Selbstverantwortung und Selbstbestimmtheit“ – eine qualitative Auswertung von traumatisierenden Geburtserlebnissen in Relation zum Geburtsmodus

Cited by 4 publications

References 46 publications

Adverse Experiences during Childbirth – a mixed-methods study based on birth reports

Adverse Experiences during Childbirth – a mixed-methods study based on birth reports

Are 6 more accurate than 4? The influence of different modes of delivery on postpartum depression and PTSD

Are 6 more accurate than 4? The delivery mode and its influence on postpartum depression and PTSD.

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