Shorey Shefaly, Wong Phyllis Zhi En
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Trauma Violence Abuse. 2022 Jul;23(3):748-763. doi: 10.1177/1524838020977161. Epub 2020 Dec 1.
Childbirth is usually a joyous occasion. However, a significant proportion of parents experienced traumatic childbirths and suffered post-traumatic consequences, which needs urgent attention. Therefore, this review aimed to explore and understand the traumatic childbirth experiences of parents. A systematic review of qualitative studies was done. The consolidated evidence was meta-summarized and meta-synthesized based on Sandelowski and Barroso's approach for synthesizing qualitative research. Seven electronic databases, including PubMed, CINAHL, Embase, PsycINFO, Cochrane, Scopus, and Web of Science, were searched from each database's inception to April 2020. Retrieved studies were screened using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and 19 studies were included in this review. All included studies were meta-summarized and meta-synthesized. An overarching theme, "traumatic birth: an evolving voyage," with three main themes, (1) "proceedings to traumatic birth," (2) "internal and external battles," and (3) "muddling through to beating the odds," and 10 subthemes were identified. Overall, parents felt fluctuations of emotions that seemed to be never-ending journeys. They expressed that various factors led to their traumatic birth experiences, especially health care providers' dismissive attitudes. Parents commonly reported feelings of powerlessness and fear for the safety of mothers and infants. Their constant battles to overcome traumatic experiences affected some of their relationships. To deal with the trauma, some mothers displayed avoidance behaviors while others relied on social support. As health care providers play important roles in influencing outcomes of childbirth, they should be mindful of the care provided during labors and childbirths.
分娩通常是一个欢乐的时刻。然而,相当一部分父母经历了创伤性分娩,并遭受了创伤后后果,这需要紧急关注。因此,本综述旨在探索和了解父母的创伤性分娩经历。我们对定性研究进行了系统综述。基于桑德洛维茨和巴罗索合成定性研究的方法,对综合证据进行了元总结和元综合。从每个数据库创建至2020年4月,我们检索了七个电子数据库,包括PubMed、CINAHL、Embase、PsycINFO、Cochrane、Scopus和Web of Science。使用系统评价和Meta分析的首选报告项目指南对检索到的研究进行筛选,本综述纳入了19项研究。对所有纳入研究进行了元总结和元综合。确定了一个总体主题,即“创伤性分娩:一段不断演变的旅程”,以及三个主要主题,(1)“创伤性分娩的过程”,(2)“内部和外部斗争”,(3)“战胜困难”,以及10个子主题。总体而言,父母们感到情绪波动,这似乎是永无止境的旅程。他们表示,各种因素导致了他们的创伤性分娩经历,尤其是医护人员的轻视态度。父母们普遍报告感到无助,担心母亲和婴儿的安全。他们为克服创伤经历而持续进行的斗争影响了他们的一些人际关系。为了应对创伤,一些母亲表现出回避行为,而另一些则依赖社会支持。由于医护人员在影响分娩结果方面发挥着重要作用,他们应该注意分娩过程中提供的护理。