Centre for Maternal and Child Health, School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, United Kingdom.
Centre for Maternal and Child Health, School of Health Sciences, City, University of London, Northampton Square, London, EC1V 0HB, United Kingdom.
Midwifery. 2022 Nov;114:103460. doi: 10.1016/j.midw.2022.103460. Epub 2022 Aug 13.
Maternity health professionals (MHPs) caring for women may witness or be involved in traumatic births. This can be associated with MHPs experiencing secondary traumatic stress (STS) or probable post-traumatic stress disorder (PTSD), which may impact MHPs emotionally and physically. The aims of this review were therefore to determine: (i) the prevalence of STS and PTSD in maternity health professionals; and (ii) the impact of witnessing birth trauma on maternity health professionals.
A mixed-methods systematic review was carried out by conducting literature searches on CINAHL, MEDLINE, PsychARTICLES, PsychINFO and PsychTESTS databases. Searches were conducted from the inception of databases up to February 2022 using search terms on MHPs and birth trauma combined. Methodological quality and bias were assessed. Data were synthesised using thematic synthesis.
A total of 18 studies were included in the review. Sample size ranged from 9 to 2,165 (total N = 8,630). Participants included midwives, nurses and obstetricians aged 18-77 years. Many MHPs had witnessed a traumatic birth event (45% - 96.9%) with the prevalence of STS ranging from 12.6%-38.7% and the proportion of participants meeting diagnostic criteria for PTSD ranging from 3.1%-46%. MHPs reported positive and negative effects associated with witnessing traumatic birth events. Synthesis of quantitative and qualitative papers identified five themes: Negative emotions and symptoms; Responsibility and regret; Impact on practice and care; Challenging professional identity; and Team support being essential.
Witnessing traumatic birth events is associated with profound emotional and physical impacts on MHPs, signifying the importance of acknowledging and addressing this in the maternity workforce. It is important to raise awareness of the impact of birth trauma on MHPs. Effective education and training guidelines, a supervisory network, ways to change practice and policy, and support and treatment should be provided to assist and improve the outcomes and work-life of MHPs' who witness traumatic births.
照顾女性的产妇健康专业人员（MHP）可能会目睹或参与创伤性分娩。这可能会导致 MHP 经历继发性创伤性应激（STS）或可能的创伤后应激障碍（PTSD），这可能会对 MHP 造成身体和情绪上的影响。因此，本综述的目的是确定：（i）产妇健康专业人员中 STS 和 PTSD 的患病率；（ii）目睹分娩创伤对产妇健康专业人员的影响。
通过对 CINAHL、MEDLINE、PsychARTICLES、PsychINFO 和 PsychTESTS 数据库进行文献检索，开展了一项混合方法系统综述。搜索从数据库创建开始，一直进行到 2022 年 2 月，使用了关于 MHP 和分娩创伤的组合搜索词。评估了方法学质量和偏倚。使用主题综合法对数据进行综合。
本综述共纳入了 18 项研究。样本量范围为 9 至 2165 人（总 N=8630 人）。参与者包括年龄在 18-77 岁的助产士、护士和产科医生。许多 MHP 目睹过创伤性分娩事件（45%-96.9%），STS 的患病率范围为 12.6%-38.7%，符合 PTSD 诊断标准的参与者比例范围为 3.1%-46%。MHP 报告了与目睹创伤性分娩事件相关的积极和消极影响。对定量和定性论文的综合分析确定了五个主题：负面情绪和症状；责任和遗憾；对实践和护理的影响；挑战专业身份；团队支持至关重要。
目睹创伤性分娩事件与 MHP 身心上的深刻影响有关，这表明在产妇劳动力中承认和解决这一问题的重要性。提高对 MHP 分娩创伤影响的认识很重要。应提供有效的教育和培训指南、监督网络、改变实践和政策的方法、支持和治疗，以帮助和改善目睹创伤性分娩的 MHP 的结果和工作生活。
