Women’s experiences of emotionally and psychologically traumatic birth; hegemony and authoritarianism in Victorian public maternity settings
Creators: name: Yates, Arimaya
Publisher: name: RMIT University
Year: 2024
Subjects: classificationCode: 320299
subject: Clinical sciences not elsewhere classified
classificationCode: 520304
subject: Health psychology

description: Background: Contemporary birthing practises in Australia pose a medicalised technological environment whereby women’s needs are often secondary to the hospital-medical environment. As a result of the increased removal of human connection and touch, there have been reports of increased desensitisation, even disembodiment of midwives and obstetricians from the labouring woman, and an associated increase in birth trauma experiences in maternity care settings. Despite current studies of women’s trauma when involved in a caesarean section, instrumental delivery or other emergency scenario, however little research has been done into women’s lived experiences of psychological and emotional trauma related to vaginal births. Contemporary birthing practices inside Victorian metropolitan public maternity hospitals within Australia pose significant risk of psychological and emotional trauma to mothers experiencing vaginal births.<br><br>Method: This study employed a qualitative exploratory descriptive approach. Selection criteria included: First time mothers who gave birth within the last year in a maternity hospital in Australia, had a vaginal birth with no instruments, experienced some perceived form of self-reported birth trauma, live in the northern corridor of Melbourne, a permanent resident of Australia, able to converse in fluently in English, over 20 years of age. Exclusion criteria: obstetric co-morbidity (for example. Pre-eclampsia, gestational diabetes), recent immigrant to Australia - less than five years, psychiatric co-morbidity, complex birth event, caesarean and twins. Women were recruited who birthed within a Melbourne metropolitan public maternity hospital. This was a convenience sample of women who had a traumatic birthing experience. Data were collected using an in-depth semi structured interview and data saturation was achieved after seven interviews.<br><br>Results: The data analysis revealed nine themes, I was determined to birth naturally; Not telling me what they were doing; I just had to force her to be born; I felt traumatised; it was really horrific; I know that is just what the system is like… they’re hospital midwives… they’re medical; I didn’t feel connected to them; She stood up for me/ I felt powerful; After the birth, just horrible/ Your stuck with the consequences; I deserve a better birth. These themes each identified areas of deep distress for the women leading to perceived traumas exacerbated by midwifery and obstetrical procedures and attitudes. Women experienced varying degrees of trauma, ranging from wishing they would die to feeling as though they were violently assaulted. One of the most commonly reported experiences for women in the study was that they felt powerless, out of control, ignored and abandoned by the midwives and obstetricians. The actions or inactions of midwives and obstetricians had a direct involvement to how women perceived their trauma. A series of recommendations for better midwifery practice were made including introducing a maternity care model based on caseload midwifery practices, improved antenatal education and continued postnatal support through debriefing of a woman’s birth event.<br><br>Conclusion: Key findings included the new discovery that birth trauma perceptions are not exclusive to actual obstetrical acts during labour and birth. Rather that a vaginal birth can hold equally as much of a traumatic impact than, for example, a caesarean or emergency forceps birth. The results highlighted the depth of trauma for women experiencing vaginal births within metropolitan Melbourne public maternity hospitals. These findings emphasise the need for changes to hospital processes including antenatal education, midwifery and obstetrician education, staff attitudes and women’s capacity to act assertively during labour.<br><br>