Giliane Fenech
Edge Hill University
A 2010 midwifery graduate from the University of Malta. She received a PhD scholarship from the University of Central Lancashire while working at Liverpool Women's Hospital NHS Foundation Trust. She became a midwifery lecturer at Edge Hill University in 2017. Her research focus is the salutogenic continuum of childbirth experiences.
Background
A satisfying birth can represent a ‘peak’ experience but can also be traumatic. There has been an exponential increase in literature focusing on predictors and experience of traumatic childbirth, and its implications. However, there is a lack of understanding into what predicts a positive childbirth experience.
Objective
To undertake a review to identify which psychosocial variables have been examined to predict the outcome of different childbirth experiences and to identify which psychosocial variables have been shown to be influenced by the birth experience in the postnatal period.
Method
An in-depth literature search across 4 databases [Medline, PsychINFO, CINAHL and Cochrane Library] using a range of keywords and their truncations was undertaken. Quality appraisal was conducted and analysis using a thematic approach was carried out.
Findings
The review included 19 papers which focused on predictors and outcomes of childbirth experiences. The studies demonstrate how certain vulnerability factors during pregnancy and birth may increase the likelihood of experiencing a negative birth or develop post-traumatic stress symptoms. These include a history of mental illness, intrapartum dissociation and unmet expectations. Protective factors which promote a more positive childbirth experience have also been identified, particularly relating to perceived control during labour. Furthermore, some implications in the postnatal period are possible following a negative birth experience, including postpartum depression, fear of childbirth and increased anxiety.
Discussion
The results of the review resonate with recent literature which confirm the dearth of available literature concerning positive birth experiences, emphasising the need for further research to fill this gap. Despite an array of research exploring risk factors and implications of PTSD, this review also suggests that such factors may differ from those that influence birth experiences and should be examined separately. Additionally, most of the variables identified in this review are pathogenic and do not capture the range of emotions, beliefs, characteristics and experiences that women can experience during the perinatal period.
Conclusions
This review shows that there has been a focus on negative childbirth experiences, both in terms of risks and aftermath of traumatic birth. An enhanced understanding of the range of experiences is required to support women’s rights in achieving a positive birth.
The identification and examination of relevant outcomes relating to labour and birth , Social and cultural precursors and consequences of optimal childbirth , Emotional and spiritual aspects of labour and birthing
