Background: Around one third of women experience childbirth trauma, with 3-15% developing Postpartum Posttraumatic Stress Disorder (PP-PTSD).
Aim: Explore birth satisfaction and health perception across two groups of postnatal women with either high or low trauma scores.
Method: Forty postnatal women were divided into groups dependent upon Posttraumatic Stress Disorder Checklist (PCL-5) scores: high-severity (n=20; range 25-57) or low-severity (n=20; range 0-7). Semi-structured interviews explored women’s childbirth experiences related to birth satisfaction and reports of postnatal health. Thematic analysis was performed.
Findings: Narrative content differed appreciably between High(A) and Low(B) scoring groups. Group A narratives were more negative (A1: Overall, a negative recall), referencing lack of autonomy, support or being heard (A2: Missing needs) and negative influences (A3: Disrupting my bubble). Group B recalled more birth satisfaction (B1: Mostly positive recall) associated with (B2: Autonomy; B3: Being cared for; B4: Intuition, instinct, and primal force). Group A narratives focused strongly on mental health (A4: Reduced awareness; A6 Experiencing PTSD; A7: Needing help); with some focus on physical health (A5: How I feel physically); Group B spoke less about health (B5: My health).
Discussion: High-quality psychological care during labour, with continuity, choice, support, and control, alongside postnatal health follow-up may improve birth satisfaction and reduce incidence of PP-PTSD.
Conclusion: To increase birth satisfaction and reduce trauma maternity care providers must be supported to prioritise high-quality psychological care to women during labour, providing choice, control, and continuity within trusting relationships. Trusting relationships are key to ongoing conversations regarding health and seeking/receiving help. Routine birth satisfaction screening and education for care providers about signs of trauma are important.