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What about me? The loss of self through the experience of traumatic childbirth.

Midwifery 2017 August
BACKGROUND AND OBJECTIVE: birth trauma has become an increasingly recognised maternal mental health issue and has important implications for both mother and infant. The importance of subjective birth experience in the development of birth trauma has been identified and may mediate the lack of theoretical consistency in this area. The current study aims to explore the subjective experience of birth trauma among first time mothers in Ireland. It aims to separate the potential effects of peripartum depression (PPD) from this in limiting this qualitative investigation to women who reported birth trauma, without PPD.

DESIGN: mixed methods: Quantitative methods facilitated the recruitment of participants, the selection of a homogenous sample and addressed previous methodological flaws in birth trauma research. Interpretative Phenomenological Analysis (IPA) was used to explore the subjective experience of traumatic childbirth.

PARTICIPANTS: seven, first- time mothers who reported a traumatic childbirth, without significant symptoms of PPD participated.

MEASUREMENT AND FINDINGS: screening measures of birth trauma and PPD were completed by participants. A semi-structured interview was then conducted with each participant about their childbirth experience. Interviews were transcribed and analysed using IPA. The primary superordinate theme recounted how the identity and individuality of women is ignored and discounted, throughout the process of childbirth. Identity is challenged and altered as a result of women's incompatibility with the maternity system.

CONCLUSIONS: this study supports the existence of birth trauma in an Irish context and highlights the subjective experience of women as central to the development of birth trauma.

IMPLICATIONS FOR PRACTICE: acknowledgement and inclusion of the mother as an individual throughout the process of childbirth may be protective in limiting the experience of birth trauma.

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