Reed Rachel, Sharman Rachael, Inglis Christian
University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, QLD, 4556, Australia.
The University of Notre Dame, 160 Oxford St, Sydney, NSW, 2010, Australia.
BMC Pregnancy Childbirth. 2017 Jan 10;17(1):21. doi: 10.1186/s12884-016-1197-0.
Many women experience psychological trauma during birth. A traumatic birth can impact on postnatal mental health and family relationships. It is important to understand how interpersonal factors influence women's experience of trauma in order to inform the development of care that promotes optimal psychosocial outcomes.
As part of a large mixed methods study, 748 women completed an online survey and answered the question 'describe the birth trauma experience, and what you found traumatising'. Data relating to care provider actions and interactions were analysed using a six-phase inductive thematic analysis process.
Four themes were identified in the data: 'prioritising the care provider's agenda'; 'disregarding embodied knowledge'; 'lies and threats'; and 'violation'. Women felt that care providers prioritised their own agendas over the needs of the woman. This could result in unnecessary intervention as care providers attempted to alter the birth process to meet their own preferences. In some cases, women became learning resources for hospital staff to observe or practice on. Women's own embodied knowledge about labour progress and fetal wellbeing was disregarded in favour of care provider's clinical assessments. Care providers used lies and threats to coerce women into complying with procedures. In particular, these lies and threats related to the wellbeing of the baby. Women also described actions that were abusive and violent. For some women these actions triggered memories of sexual assault.
Care provider actions and interactions can influence women's experience of trauma during birth. It is necessary to address interpersonal birth trauma on both a macro and micro level. Maternity service development and provision needs to be underpinned by a paradigm and framework that prioritises both the physical and emotional needs of women. Care providers require training and support to minimise interpersonal birth trauma.
许多女性在分娩过程中经历心理创伤。创伤性分娩会影响产后心理健康和家庭关系。了解人际因素如何影响女性的创伤经历，对于促进最佳心理社会结果的护理发展至关重要。
作为一项大型混合方法研究的一部分，748名女性完成了一项在线调查，并回答了“描述分娩创伤经历以及你认为造成创伤的因素”这一问题。使用六阶段归纳主题分析过程对与护理提供者的行为和互动相关的数据进行了分析。
数据中确定了四个主题：“优先考虑护理提供者的议程”；“忽视身体感知的知识”；“谎言和威胁”；以及“侵犯”。女性认为护理提供者将自己的议程置于女性需求之上。这可能导致不必要的干预，因为护理提供者试图改变分娩过程以满足自己的偏好。在某些情况下，女性成为医院工作人员观察或实践的学习资源。女性自身关于产程进展和胎儿健康的身体感知知识被忽视，而倾向于护理提供者的临床评估。护理提供者使用谎言和威胁来迫使女性遵守程序。特别是，这些谎言和威胁与婴儿的健康有关。女性还描述了虐待和暴力行为。对一些女性来说，这些行为引发了性侵犯的记忆。
护理提供者的行为和互动会影响女性分娩期间的创伤经历。有必要在宏观和微观层面解决人际分娩创伤问题。产科服务的发展和提供需要以优先考虑女性身体和情感需求的范式和框架为基础。护理提供者需要培训和支持，以尽量减少人际分娩创伤。
