Parents experiences of birth trauma in the UK: a thematic synthesis of parents experiences of healthcare staff and services surrounding traumatic birth and a qualitative exploration of solo mothers experiences of birth trauma

Abstract

OBJECTIVES: Perinatal mental health, and in particular, birth trauma, are current focuses for improvement and development within NHS services. Birth trauma is common and presents with significant risk to parental and infant outcomes. Research surrounding the views of parents who have experienced birth trauma is growing but remains limited and significantly less is known about the experiences of less ‘traditional’ family structures. In order to develop appropriate and supportive maternity and perinatal mental health services, it is essential to develop an understanding of different parents’ experiences from their perspectives. The aim of this portfolio is to synthesise research reporting on parents’ experiences of healthcare staff and services surrounding traumatic births in the UK and to explore solo mothers’ experiences of traumatic birth using interpretative phenomenological analysis (IPA).

METHODS: Thematic synthesis was utilised to systematically search and synthesise qualitative studies exploring parents’ experiences of healthcare services and staff surrounding traumatic births. Five electronic databases (Medline, CINAHL, PsychINFO, Cochrane Library and Embase) were searched. A modified Critical Appraisal Skills Programme (CASP) checklist was utilised to appraise the quality of the papers. In the empirical study, IPA was employed to explore solo mothers’ experiences of traumatic birth. Six women who self-reported being a solo mother and experiencing traumatic birth were recruited through third sector social media channels. Interviews were completed online and transcribed.

RESULTS: Ten qualitative studies were identified for the thematic synthesis. Three main themes emerged: ‘Being seen and heard,’ ‘Making connections’ and ‘The system.’ For the empirical study, one central theme was identified, ‘A story of power,’ that connected four main themes. The four themes were: ‘The experience of loss,’ ‘The value of my system,’ ‘The meaning of good healthcare’ and ‘Challenging the narrative.’ Importantly, many aspects appeared in line with experiences of other mothers, but several stood out as unique to the experiences of solo mothers.

CONCLUSIONS: The synthesis raises the importance parents place on their interactions with the healthcare service and staff in experiences of traumatic birth. It highlights that there are a number of key factors which parents would benefit from services considering in their approach and care provision. Findings from the empirical study highlight the need for individualised care for women regardless of their social context and narrative. It emphasises the importance of solo mothers’ personal systems and remembering the basics in healthcare, supporting women to feel more empowered in their birthing experiences. Clinical and research recommendations are discussed.