A metaethnography of traumatic childbirth and its aftermath: amplifying causal looping.

Integrating results from multiple analytic approaches used in a research program by the same researcher is a type of metasynthesis that has not often been reported in the literature. In this article the findings of one type of qualitative synthesis approach, a metaethnography, of six qualitative studies on birth trauma and its resulting posttraumatic stress disorder from my program of research are presented. This metaethnography provides a wide-angle lens to view and interpret the far-reaching, stinging tentacles of this often invisible phenomenon that new mothers experience. I used Noblit and Hare's seven-step approach for synthesizing the findings of qualitative studies. The original trigger of traumatic childbirth resulted in six amplifying feedback loops, four of which were reinforcing (positive direction), and two which were balancing (negative direction). Leverage points that identify where pressure in the amplifying causal loop can break the feedback loop where necessary are discussed.