a Edinburgh Napier University , Edinburgh , City of Edinburgh , Scotland.
J Reprod Infant Psychol. 2019 Feb;37(1):56-83. doi: 10.1080/02646838.2018.1504285. Epub 2018 Aug 17.
Review primary research regarding PTSD Post-Childbirth (PTSD-PC) that focussed on Quality of Provider Interaction (QPI) from the perspective of women who developed PTSD-PC, or midwives.
Up to 45% of women find childbirth traumatic. PTSD-PC develops in 4% of women (18% in high-risk groups). Women's subjective experiences of childbirth are the most important risk factor in the development of PTSD-PC, with perceived QPI being key.
A systematic search was performed for PTSD-PC literature. Reviewed papers focussed on either women's subjective childbirth experiences, particularly QPI, or midwives' perspectives on QPI. Study quality was assessed using the Critical Appraisal Skills Programme (CASP) tools, and a narrative synthesis of findings produced.
Fourteen studies were included. Three features of QPI contribute towards developing PTSD-PC: interpersonal factors; midwifery care factors; and lack of support.
QPI is a significant factor in the development of PTSD-PC and the identified key features of QPI have potential to be modified by midwives. The development of guidelines for midwives should be grounded on evidence highlighted in this review, along with further high-quality qualitative research exploring QPI from the perspective of women with PTSD-PC, but also midwives' knowledge and needs regarding their role within QPI.
综述 PTSD 产后（PTSD-PC）的初级研究，重点关注从出现 PTSD-PC 的女性或助产士的角度来看的提供者互动质量（QPI）。
高达 45%的女性认为分娩是创伤性的。4%的女性（高危人群中 18%）会发展 PTSD-PC。女性对分娩的主观体验是 PTSD-PC 发展的最重要风险因素，感知到的 QPI 是关键。
对 PTSD-PC 文献进行了系统检索。综述的论文重点关注女性的主观分娩体验，特别是 QPI，或助产士对 QPI 的看法。使用批判性评估技能计划（CASP）工具评估研究质量，并对研究结果进行叙述性综合。
纳入了 14 项研究。QPI 的三个特征有助于 PTSD-PC 的发展：人际关系因素；助产护理因素；缺乏支持。
QPI 是 PTSD-PC 发展的一个重要因素，并且已经确定的 QPI 的关键特征有可能被助产士修改。应根据本综述中强调的证据以及进一步的高质量定性研究，为助产士制定指南，这些研究探讨了 PTSD-PC 女性以及助产士对 QPI 及其在其中的角色的知识和需求。
