J Reprod Infant Psychol. 2019 Feb;37(1):56-83. doi: 10.1080/02646838.2018.1504285. Epub 2018 Aug 17.

PTSD post-childbirth: a systematic review of women's and midwives' subjective experiences of care provider interaction.

Patterson J1, Hollins Martin C1, Karatzias T1.

Author information

1

a Edinburgh Napier University , Edinburgh , City of Edinburgh , Scotland.

Abstract

OBJECTIVE:

Review primary research regarding PTSD Post-Childbirth (PTSD-PC) that focussed on Quality of Provider Interaction (QPI) from the perspective of women who developed PTSD-PC, or midwives.

BACKGROUND:

Up to 45% of women find childbirth traumatic. PTSD-PC develops in 4% of women (18% in high-risk groups). Women's subjective experiences of childbirth are the most important risk factor in the development of PTSD-PC, with perceived QPI being key.

METHODS:

A systematic search was performed for PTSD-PC literature. Reviewed papers focussed on either women's subjective childbirth experiences, particularly QPI, or midwives' perspectives on QPI. Study quality was assessed using the Critical Appraisal Skills Programme (CASP) tools, and a narrative synthesis of findings produced.

RESULTS:

Fourteen studies were included. Three features of QPI contribute towards developing PTSD-PC: interpersonal factors; midwifery care factors; and lack of support.

CONCLUSION:

QPI is a significant factor in the development of PTSD-PC and the identified key features of QPI have potential to be modified by midwives. The development of guidelines for midwives should be grounded on evidence highlighted in this review, along with further high-quality qualitative research exploring QPI from the perspective of women with PTSD-PC, but also midwives' knowledge and needs regarding their role within QPI.

KEYWORDS:

PTSD; childbirth; maternity care; midwives; systematic review
pubmed link: https://www.ncbi.nlm.nih.gov/pubmed/30114935

PMID:

 

30114935

 

DOI:

 

10.1080/02646838.2018.1504285