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“It can’t be like last time” – choices made in early pregnancy by women who have previously experienced a traumatic birth

Greenfield, Mari; Jomeen, Julie; Glover, Lesley

Authors

Mari Greenfield



Abstract

Background: A significant number of women experience childbirth as traumatic. These experiences are often characterized by a loss of control coupled with a perceived lack of support and inadequate communication with health care providers. Little is known about the choices women make in subsequent pregnancy(s) and birth(s), or why they make these choices. This study aimed to understand these choices and explore the reasons behind them.
Methods: A longitudinal grounded theory methods study involving nine women was conducted. Over half of the participants had a formal diagnosis of post-traumatic stress disorder (PTSD) and/or PND related to the previous birth. Interviews were carried out at three timepoints perinatally. These findings are from the first interviews at 12–20 weeks.
Results: From the first days of pregnancy, this cohort of women were focused on concerns that this birth would be a repeated traumatic experience. The women were deliberately searching out and analyzing information about their choices in this pregnancy and birth, and making plans which had two aims; firstly to avoid a repeat of their previous birth experience and secondly to avoid a loss of control to other people during the birth. The women considered a range of birth choices, from elective cesareans to freebirth. Some women felt well supported by those around them, including care providers, partners, friends, and family. Others did not feel supported and were anticipating conflict in trying to assert their birth choices. Many early relationships with healthcare professionals were characterized by fear and mistrust.
Discussion: If women who have previously experienced a traumatic birth become pregnant again, they have a strong desire to avoid a repeat experience and to feel in control of their birth choices. Access to robust information appears to help reduce uncertainty and arm women in their discussions with professionals. Similarly making plans and seeking to have them agreed with care providers at an early stage is used a way to reduce the risk of having a further traumatic experience. Implications for practice include supporting women in formulating and confirming pregnancy and birth plans at an early stage to reduce uncertainty and foster a sense of control.

Journal Article Type Article
Publication Date Jan 25, 2019
Journal Frontiers in Psychology
Print ISSN 1664-1078
Publisher Frontiers Media
Peer Reviewed Peer Reviewed
Volume 10
Article Number 56
APA6 Citation Greenfield, M., Jomeen, J., & Glover, L. (2019). “It can’t be like last time” – choices made in early pregnancy by women who have previously experienced a traumatic birth. Frontiers in psychology Frontiers Research Foundation, 10, https://doi.org/10.3389/fpsyg.2019.00056
DOI https://doi.org/10.3389/fpsyg.2019.00056
Keywords Traumatic birth; Birth trauma; Choice; Control; Pregnancy; Support; Maternity
Publisher URL https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00056/full

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Copyright Statement
Copyright © 2019 Greenfield, Jomeen and Glover. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.







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