School of Health & Social Care, Edinburgh Napier University, 9 Sighthill Court, Edinburgh EH11 4BN, Scotland, UK; Artesis Plantijn University of Applied Sciences, Noorderplaats 2, 2000 Antwerp, Belgium.
School of Community Health & Midwifery, University of Central Lancashire, Preston, Lancashire PR1 2HE, United Kingdom.
Women Birth. 2024 Feb;37(1):51-62. doi: 10.1016/j.wombi.2023.08.004. Epub 2023 Aug 30.
Understanding a woman's traumatic birth experience benefits from an approach that considers perspectives from various fields of healthcare and social sciences.
To evaluate and explore the multidisciplinary perspectives surrounding a traumatic birth experience to form a theory and to capture its structure.
A multidisciplinary advanced principle-based concept analysis was conducted, including the following systematic steps: literature review, assessment of concept maturity, principle-based evaluation, concept exploration and advancement, and formulating a multidisciplinary concept theory. We drew on knowledge from midwifery, psychology, childbirth education, bioethics, obstetric & gender violence, sociology, perinatal psychiatry, and anthropology.
Our evaluation included 60 records which were considered as 'mature'. Maturity was determined by the reported concept definition, attributes, antecedents, outcomes, and boundaries. The four broad principles of the philosophy of science epistemology, pragmatics, linguistics, and logic illustrated that women live in a political, and cultural world that includes social, perceptual, and practical features. The conceptual components antecedents, attributes, outcomes, and boundaries demonstrated that a traumatic birth experience is not an isolated event, but its existence is enabled by social structures that perpetuate the diminished and disempowered position of women in medical and institutionalised healthcare regulation and management.
The traumatic childbirth experience is a distinctive experience that can only occur within a socioecological system of micro-, meso-, and macro-level aspects that accepts and allows its existence and therefore its sustainability - with the traumatic experience of the birthing woman as the central construct.
理解女性的创伤性分娩经历需要从医疗保健和社会科学的多个领域的角度来考虑。
评估和探索围绕创伤性分娩经历的多学科视角,形成一个理论并捕捉其结构。
进行了基于多学科先进原则的概念分析,包括以下系统步骤:文献综述、概念成熟度评估、基于原则的评估、概念探索和推进,以及制定多学科概念理论。我们借鉴了助产学、心理学、分娩教育、生物伦理学、产科和性别暴力、社会学、围产期精神病学和人类学的知识。
我们的评估包括 60 份被认为是“成熟”的记录。成熟度是通过报告的概念定义、属性、前因、结果和边界来确定的。科学认识论、语用学、语言学和逻辑哲学的四个广泛原则表明,女性生活在一个政治和文化的世界中,包括社会、感知和实践特征。概念成分的前因、属性、结果和边界表明,创伤性分娩经历不是一个孤立的事件,而是由社会结构所允许的,这些社会结构使女性在医疗和制度化的医疗保健监管和管理中的弱势和无权地位永久化。
创伤性分娩经历是一种独特的经历,只能在微观、中观和宏观层面的社会生态系统中发生,这个系统接受并允许其存在,因此也允许其持续存在——以分娩妇女的创伤性经历为中心结构。