Developing A Novel Conceptual Framework for Understanding Childbirth Trauma: An Integrative Review
Board Location: #197
Discipline: Social, Behavioral, and Economic Sciences
Session: 2
Kasia Allen - CUNY Brooklyn College
Co-Author(s): Farah Qureshi, ScD, Johns Hopkins Bloomberg School of Public Health, Department of Population, Family, and Reproductive Health, Baltimore, MD, USA Celia Karp, PhD, Johns Hopkins Bloomberg School of Public Health, Department of Population, Family, and Reproductive Health, Baltimore, MD, USA
Birth trauma is a significant issue affecting maternal health, with implications for psychological and physical well-being. Prior research has primarily focused on the psychological experiences of mothers’ post-childbirth, such as childbirth-related posttraumatic stress disorder (PTSD). However, traumatic birth experiences encompass various forms of trauma, including physical injuries such as severe perineal tearing and emergency cesarean sections, as well as emotional scars from feelings of mistreatment or disrespect in healthcare settings during and after childbirth. Moreover, there is trauma linked to negative neonatal events and the subsequent hospitalization of newborns. These studies often treat each dimension separately without considering a comprehensive perspective. We hypothesize that a multidimensional perspective will better explain the effects of childbirth trauma on maternal and infant outcomes. This research aims to address critical gaps in how childbirth trauma is studied and understood, particularly the interactions between these dimensions. We conducted an integrative review of the literature focusing on four dimensions of childbirth trauma: psychological trauma, physical trauma, health-system related trauma, and trauma related to adverse neonatal outcomes. Controls involved excluding works that did not primarily address one of the four dimensions, non-empirical studies, and grey literature. The review revealed several key preliminary findings: Most studies focused on severe perineal tearing and emergency cesarean sections, which are often linked with psychological trauma. There is less research on postpartum hemorrhage and severe maternal morbidity, and limited understanding of the long-term effects of physical trauma on both the birthing person and the broader family; research has extensively covered PTSD related to childbirth, but there is a notable gap in studies on postpartum depression (PPD) and anxiety associated with traumatic birth experiences; Few studies have explored disrespect and mistreatment during childbirth, often described as obstetric violence. Additionally, there is limited research on healthcare providers’ perspectives on psychological disorders related to traumatic birth experiences; Some research has focused on the impact of traumatic birth experiences on the child, particularly in NICU settings, with comparisons between the impacts on the mother and child. However, further exploration is needed to understand maternal outcomes fully. Our expansive approach offers a novel contribution to the field, highlighting its multidimensional core that encompasses not only the physical ordeals of mothers but also their engagements with the healthcare system throughout the stages of labor, delivery, and postpartum care, especially in cases where their newborn requires hospitalization shortly after birth. Future research should address obstetric violence and trauma interventions.
Funder Acknowledgement(s): 1. Diversity Summer Internship Program (DSIP) 2. Office of Inclusion Diversity Anti-Racism and Equity (IDARE) 3. Leadership Alliance 4. NYS CSTEP (#54882) at Brooklyn College
Faculty Advisor: Dr. Farah Qureshi, fqureshi@jhu.edu
Role: My research role involved conducting an integrative review to explore maternal and infant outcomes across various delivery settings. I developed a comprehensive search strategy to identify relevant literature, utilizing specific keywords and database filters. Additionally, I performed the abstract and title screening to ensure the inclusion of studies meeting the eligibility criteria. This work is still in progress, contributing to the foundation of our data synthesis and analysis.