Empowered or powerless? Contributing factors to women's appraisal of traumatic childbirth

2021 ◽  
Vol 29 (12) ◽  
pp. 674-682
Author(s):  
Grace Baptie ◽  
Elena Mueller Januário ◽  
Alyson Norman
Keyword(s):  
Thematic Analysis ◽  
Maternity Care ◽  
Traumatic Event ◽  
Healthcare Services ◽  
Traumatic Experience ◽  
Sense Of Control ◽  
Birth Experience ◽  
Structured Interviews ◽  
Contributing Factors ◽  
Traumatic Childbirth

Background Approximately one-third of women reflect on childbirth as a traumatic experience and the way women appraise their birth experience is significant to their postnatal wellbeing. This study aimed to identify and compare experiences of childbirth for mothers who reflect on birth as a traumatic or non-traumatic event. Methods Semi-structured interviews were conducted with 14 mothers in the postpartum period who appraised their birth as either traumatic or non-traumatic. The data were analysed using thematic analysis to elicit themes and subthemes. Results Thematic analysis revealed two contrasting themes relating to whether women felt empowered or powerless during birth. Empowerment was associated with women's trust in their maternity care, the sense of control they felt over their body and birth and the extent to which they felt informed of their options. Being powerless was associated with distrust towards healthcare services, feeling as though they lacked control over the process and feeling ‘in the dark’ about what was happening. Conclusions Women's sense of empowerment during birth is an important contributor to the appraisal of childbirth as a traumatic or non-traumatic experience. Empowerment is largely determined by the dynamic between a mother and the support around her.

Narrative integration of identity following trauma Life-stories of immigrants granted asylum in Australia following prolonged detention

2016 ◽  
Vol 26 (1) ◽  
pp. 88-107 ◽  
Author(s):  
Andrew J. Witney ◽  
Glen Bates
Keyword(s):  
Thematic Analysis ◽  
Asylum Seekers ◽  
Traumatic Event ◽  
Traumatic Experiences ◽  
Structured Interviews ◽  
Detention Centers ◽  
Proposed Model ◽  
Therapeutic Context ◽  
Robust Integration ◽  
Different Levels

Drawing on narrative theories of personality this study proposed a model of narrative integration to explain how traumatic experiences are incorporated within the self-construct. A qualitative design was employed, using semi-structured interviews and thematic analysis of interview data. The sample included former asylum-seekers now living in Australia after spending two years or more in mandatory detention centers. Ten males aged between 19 and 51 recalled their experiences of mandatory detention within the context of their lives. Findings supported the use of the proposed model of narrative integration for understanding trauma associated with mandatory detention. Thematic analysis revealed disturbances to people’s narratives as a result of detention, with attempts to adapt to narrative disturbance adhering to constructs outlined in the model. Three groups representing different levels of narrative integration were identified using the model, including: robust integration, limited integration, and fragmentation. This study extended the narrative approach by offering a conceptual framework for assessing narrative integration following a traumatic event. Findings suggest scope for further research applying the model of narrative integration to other trauma populations, and exploring the utility of the model in a therapeutic context.

scholarly journals Effects of traumatic birth experience and transmission intergenerationalTravmatik doğum deneyiminin etkileri ve nesiller arası aktarımı

2018 ◽  
Vol 15 (1) ◽  
pp. 604 ◽  
Author(s):  
Nihal Aydın ◽  
Hatice Yıldız
Keyword(s):  
Traumatic Event ◽  
Future Generations ◽  
Traumatic Experience ◽  
Obstetrics And Gynecology ◽  
Negative Consequences ◽  
Birth Experience ◽  
Future Health ◽  
Traumatic Birth ◽  
Traumatic Birth Experience

The birth is an individual and also important expression for women life. This experience can be perceived in a different way by each woman that can be defined by different feelings such as positive, negative or mixed. Some women perceive birth experience as a traumatic event. Traumatically perceived birth is considered an event that may trigger Posttraumatic Stress Disorder (PTSD) reaction. It is stated that traumatic birth experience may cause permanent or long-term negative consequences in women's life, may negatively affect future health, subsequent birth experiences and family relations. It is reported that birth is part of the continuity from past to future and the effects are not limited to the woman giving birth, but also that the subsequent generations, and even the other women around it, can influence the birth perceptions and experiences. There are many studies shows that the effects of traumatic events are transmitted to the next generation. This genetic transmission suggests that traumatic birth is a serious problem not only affecting the women who will give birth to nowadays but also having long-term consequences. From today's women to future generations, obstetrics and gynecology nurses have important responsibilities to prevent of reaching traumatic experience of birth, is a natural part of women's life. In this article, it was aimed to investigate the importance of traumatic birth concept, risk factors, existing effects and future generations in the context of literature and to draw attention to the responsibilities of the obstetrics and gynecology nurses.Extended English summary is in the end of Full Text PDF (TURKISH) file. ÖzetDoğum bireyseldir ve kadın için çok yönlü önemli bir yaşam deyimidir. Bu deneyim her bir kadın tarafından farklı algılanabilmekte, olumlu, olumsuz ya da karışık farklı duygularla tanımlanabilmektedir. Bazı kadınlar ise doğum deneyimini travmatik bir olay olarak algılayabilmektedir. Travmatik olarak algılanan doğum, Posttravmatik Stres Bozukluğu (PTSB) reaksiyonunu tetikleyebilecek bir olay olarak kabul edilmektedir. Travmatik doğum deneyiminin kadının hayatında kalıcı veya uzun vadeli olumsuz sonuçlar doğurabileceği, gelecekteki sağlığını, sonraki doğum deneyimlerini ve aile içi ilişkilerini olumsuz etkileyebileceği belirtilmektedir. Doğumun geçmişten geleceğe giden devamlılığın bir parçası olduğu belirtilmekte ve etkilerinin doğum yapan kadınla sınırlı kalmayıp, onunla birlikte çevresindeki diğer kadınların ve hatta sonraki nesillerin doğum algılarını ve deneyimlerini de etkileyebildiği bildirilmektedir. Travmatik olayların etkilerinin sonraki nesillere aktarıldığını gösteren pek çok çalışma bulunmaktadır. Bu genetik aktarım travmatik doğumun da sadece günümüzde doğum yapacak kadınları etkilemeyip daha uzun vadeli sonuçları olabilecek ciddi bir sorun olduğunu göstermektedir. Kadın hayatının doğal bir parçası olan doğum eylemini günümüz kadınlarının ve gelecek nesillerin travmatik bir deneyim olarak hatırlamalarının önlenmesinde kadın doğum hemşirelerine önemli sorumluluklar düşmektedir. Bu makalede travmatik doğum kavramı, risk faktörleri, ortaya çıkan mevcut etkileri ve gelecek nesiller açısından önemini literatür bağlamında irdelemek, konuya ve kadın doğum hemşiresinin sorumluluklarına dikkat çekmek amaçlanmıştır.

Health visitors' experiences supporting families with a child who has a congenital syndrome

2020 ◽  
Vol 8 (1) ◽  
pp. 32-40
Author(s):  
Rebecca Ingleby ◽  
Marianne Piano ◽  
Pat Colliety
Keyword(s):  
Thematic Analysis ◽  
Early Years ◽  
Professional Support ◽  
Structured Interviews ◽  
Contributing Factors ◽  
Health Visitors ◽  
South East England ◽  
Families With Children ◽  
Training Professional ◽  
Congenital Syndrome

It is important for practitioners involved in a child's early years, such as health visitors, to feel confident in caring for families with a child who has a named syndrome or syndrome without a name (SWAN). Health visitors' perspectives on their capacity to support these families are yet to be examined in the literature. Therefore, this study aimed to explore health visitors' perceived roles and confidence when caring for families with children who have a named syndrome or SWAN. Semi-structured interviews involving 10 health visitors, working across three community teams in south-east England, fulfilled the research aims. Interviews were transcribed verbatim for thematic analysis. Perceived lack of training, professional support and subsequently practitioner confidence were contributing factors to health visitors' feelings when supporting these families.

La Crisis de la Atención de Maternidad: Experts’ Perspectives on the Syndemic of Poor Perinatal Health Outcomes in Puerto Rico

2021 ◽  
Vol 80 (1) ◽  
pp. 2-16
Author(s):  
Holly Horan ◽  
Melissa Cheyney ◽  
Yvette Piovanetti ◽  
Vanessa Caldari
Keyword(s):  
Puerto Rico ◽  
Health Outcomes ◽  
Puerto Rican ◽  
Maternity Care ◽  
Infant Health ◽  
Perinatal Care ◽  
Perinatal Health ◽  
Care Providers ◽  
Structured Interviews ◽  
Contributing Factors

The purpose of this study was to center the voices of maternal and infant health care (MIH) clinicians and public health experts to better understand factors associated with persistently high rates of poor perinatal health outcomes in Puerto Rico. Currently, Puerto Rican physicians, midwives, and other care providers’ perspectives are absent from the literature. Guided by a syndemics framework, data were collected during eighteen months of ethnographic fieldwork and through open-ended, semi-structured interviews (n=20). Three core themes emerged. The first two themes: (1) Los estresores diarios: poor nutrition, contaminated water, and psychosocial stress; and (2) Medicina defensiva: solo obstetrics and fear-based medicine, describe contributing factors to Puerto Rico’s high preterm and cesarean birth rates. The third theme: (3) Medicina integrada: midwives, doulas, and comprehensive re-education explores potential solutions to the island’s maternity care crisis that include improved integration of perinatal care services and educational initiatives for both patients and providers. Collectively, participants’ narratives expose a syndemic of poor perinatal health outcomes that emerges from the structural vulnerability generated by decades of colonial domination embedded in the daily lives of island residents and in the Puerto Rican maternity care system.

scholarly journals Lived Traumatic Childbirth Experiences of Newly Delivered Mothers Admitted to the Postpartum Ward: a Phenomenological Study

2019 ◽  
Vol 8 (1) ◽  
pp. 23-31 ◽  
Author(s):  
Sedigheh Abdollahpour ◽  
Zahra Motaghi
Keyword(s):  
Human Dignity ◽  
Phenomenological Study ◽  
Traumatic Event ◽  
Stressful Event ◽  
Clinical Experiences ◽  
Emotional Experiences ◽  
Structured Interviews ◽  
Negative Effects ◽  
Colaizzi's Method ◽  
Traumatic Childbirth

Introduction: Childbirth is a stressful event in every woman's life, leading to traumatic deliveries in half of the cases. This study aimed at describing mothers’ lived experiences which make them perceive their childbirth as traumatic. Methods: In this descriptive phenomenological study, based on the DSM-V-A criteria, 32 mothers who had perceptions of a traumatic event during their labor and delivery were explored through semi-structured interviews, and the collected data were analyzed using the Colaizzi’s method. Results: Four main themes could be extracted from the experiences of the mothers. The first theme was sensational and emotional experiences followed by clinical experiences, legal experiences and human dignity, and environmental experiences. The sensational and emotional experiences included four main categories (anxiety, fear, sorrow, anger). The theme of clinical experiences included two main categories (avoidable and unavoidable childbirth complications). The theme of legal experiences and human dignity included two main categories (non-observance of the charter of patient rights, and non-observance of human rights). The theme of environmental experiences also included two main categories (lack of proper supervision and management). Conclusion: To prevent traumatic childbirth and its negative effects, different psychological aspects of childbirth need to be identified.

scholarly journals Incidence and associated factors with traumatic childbirth in postpartum Brazilian woman

2016 ◽  
Vol 13 (2) ◽  
pp. 5-12 ◽  
Author(s):  
Carla Fonseca Zambaldi ◽  
Amaury Cantilino ◽  
Jacqueline Vasconcelos Farias ◽  
Gustavo Paranhos Moraes ◽  
Everton Botelho Sougey
Keyword(s):  
Pain Score ◽  
Traumatic Event ◽  
Traumatic Experience ◽  
Obstetrical Complications ◽  
Dissociative Experiences ◽  
Risk Pregnancy ◽  
Brazilian Woman ◽  
High Pain Score ◽  
Previous Trauma ◽  
Traumatic Childbirth

Childbirth may be a traumatic experience for some women. This observational study aimed to describe the incidence of traumatic childbirth in two regional maternity services in Brazil. In addition, the study intended to determine characteristics that are associated with traumatic childbirth. A total of 328 women were interviewed, up to 72 hours postpartum, between July and November 2010. Women were screened for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSMI-IV) criteria for traumatic event using the item A of SCID-I interview for PTSD. Socio-demographic and obstetrical variables, pain score, previous trauma and dissociative experiences in women with and without traumatic childbirth were compared. A total of 53 (16.2%) of the sample fulfilled the criteria for a traumatic event.  It observed that some socio-demographic and obstetrical variables may be considered as associated with traumatic childbirth, such as an intermediate level of schooling, high risk pregnancy, obstetrical complications during pregnancy, primiparity, a high pain score, forceps, episiotomy, prematurity, obstetrical complications at birth or with the baby, baby needing hospital care, dissociative experience peripartum, no satisfaction with maternity care, not being well informed of the progress of labor and previous trauma related to urban violence, sexual abuse or domestic violence. Childbirth may be a traumatic event for Brazilian. In this sample traumatic childbirth was associated with pain, previous trauma, dissociative experiences and some socio-demographic and obstetrical variables. Traumatic childbirth constitutes an important mental health problem and need more attention from health.

The Experience of Disgust in Women Exposed to Domestic Violence in Turkey

2021 ◽  
pp. 088626052110139
Author(s):  
Seray Akça ◽  
Faruk Gençöz
Keyword(s):  
Domestic Violence ◽  
Sexual Abuse ◽  
Interpretative Phenomenological Analysis ◽  
Qualitative Methodology ◽  
Life Experiences ◽  
Traumatic Event ◽  
Phenomenological Analysis ◽  
Traumatic Experience ◽  
Limited Information ◽  
Structured Interviews

In trauma, fear as a basic emotion that evokes avoidance after exposure to a traumatic event is important for posttraumatic process. Another emotion causing avoidance is disgust. Despite the fact that disgust also plays an important role in trauma, there is limited information about how it is experienced during and after exposure to the traumatic event. In this study, the aim was to understand how women experience disgust during and after domestic violence, as a prolonged and repeated traumatic experience, and how they try to cope with disgust evoking situations in this process. For this aim, qualitative methodology was used. With purposive sampling, six women exposed to domestic violence including physical, verbal and sexual abuse were interviewed. With each woman, approximately seven semi-structured interviews were completed. Forty-one interviews were audio recorded and transcribed. Data was analyzed by Interpretative Phenomenological Analysis. At the end of the analysis, three superordinate themes, namely, experience of perpetrator-directed disgust with gustatory expressions of moral disgust and association of disgust in domestic abuse to daily life experiences; experience of self-disgust with two themes of internalization of assault without awareness and contamination by sexual abuse; coping with disgust in domestic violence with four subthemes, namely, avoidance from perpetrator, reidentification of the perpetrator with substitutive identity, alienation from self, reidentification of self with new relationships were constructed. Results showed that disgust is experienced in a repressed way as a result of the aversive nature of traumatic experience. The results were evaluated in psychological, social and cultural contexts. Their implications for understanding disgust in domestic violence were discussed.

scholarly journals What have we learnt from measles outbreaks in 3 English cities? A qualitative exploration of factors influencing vaccination uptake in Romanian and Roma Romanian communities

2020 ◽  
Author(s):  
Sadie Bell ◽  
Vanessa Saliba ◽  
Mary Ramsay ◽  
Sandra Mounier-Jack
Keyword(s):  
Large Scale ◽  
Healthcare Services ◽  
Vaccine Uptake ◽  
Service Access ◽  
Structured Interviews ◽  
Contributing Factors ◽  
Outbreak Response ◽  
Vaccination Uptake ◽  
Factors Influencing ◽  
Measles Outbreaks

Abstract Background: Since 2016, large scale measles outbreaks have heavily affected countries across Europe. In England, laboratory confirmed measles cases increased almost four-fold between 2017 and 2018, from 259 to 966 cases. Several of the 2017-18 measles outbreaks in England particularly affected Romanian and Roma Romanian communities, with the first outbreaks in these communities occurring in Birmingham, Leeds and Liverpool. This study explored factors influencing vaccination behaviours amongst Romanian and Roma Romanian communities in these three cities. Methods: Across Birmingham, Leeds and Liverpool, we conducted semi-structured interviews with 33 key providers to explore their experience in delivering vaccinations and managing the outbreak response. We also interviewed 9 Romanian women in one of the cities to explore their vaccination attitudes and behaviours. To categorise factors affecting vaccination we applied the 5As Taxonomy for Determinants of Vaccine Uptake (Access, Affordability, Awareness, Acceptance and Activation) during data analysis. Findings: Factors related to access and acceptance, such as language and literacy, ease of registering with a general practice, and trust in health services, were reported as the main barriers to vaccination amongst the communities. Concerns around vaccination safety and importance were reported but these appeared to be less dominant contributing factors to vaccination uptake. The active decline of vaccinations amongst interviewed community members was linked to distrust in healthcare services, which were partly rooted in negative experiences of healthcare in Romania and the UK. Conclusion: Access and acceptance, dominant barriers to vaccination, can be improved through the building of trust with communities. To establish trust providers must find ways to connect with and develop a greater understanding of the communities they serve. To achieve this, cultural and linguistic barriers need to be addressed. Better provider-service user relationships are crucial to reducing vaccination inequalities and tackling broader disparities in health service access.

scholarly journals Meaning-making process related to temporality during breast cancer traumatic experience: The clinical use of narrative to promote a new continuity of life

2016 ◽  
Vol 12 (4) ◽  
pp. 622-634 ◽  
Author(s):  
Maria Luisa Martino ◽  
Maria Francesca Freda
Keyword(s):  
Breast Cancer ◽  
Thematic Analysis ◽  
Time Perspective ◽  
Biological Therapy ◽  
Meaning Making ◽  
Traumatic Event ◽  
Well Being ◽  
Traumatic Experience ◽  
Clinical Use ◽  
Breast Cancer Patients

Previous research has agreed that meaning-making is a key element in the promotion of patients’ well-being during and after a traumatic event such as cancer. In this paper, we focus on an underestimated key element related to the crisis/rupture of this meaning-making process with respect to the time perspective. We consider 40 narratives of breast cancer patients at different times of treatment, undergoing chemotherapy and biological therapy. We collected data through writing technique. We performed an interpretative thematic analysis of the data and highlighted specific ways to signify time during the different treatment phases. Our central aspect “the time of illness, the illness of time” demonstrates that the time consumed by illness has the risk of becoming an illness of time, which transcends the end of the illness and absorbs a patient’s past, present, and future, thus saturating all space for thought and meaning. The study suggests that narrative can become a therapeutic and preventive tool for women with breast cancer in a crisis of temporality, and enable the promotion of new semiotic connections and a specific functional resynchronization with the continuity/discontinuity of life. This is useful during the illness and medical treatment and also after the treatment.

‘Are we on the same wavelength?’ International nurses and the process of confronting and adjusting to clinical communication in Australia

2017 ◽  
Vol 13 (3) ◽  
pp. 263-274 ◽  
Author(s):  
Tonia Crawford ◽  
Peter Roger ◽  
Sally Candlin
Keyword(s):  
Communication Skills ◽  
Thematic Analysis ◽  
Care Setting ◽  
Linguistically Diverse ◽  
The Other ◽  
Culturally And Linguistically Diverse ◽  
Central Theme ◽  
Structured Interviews ◽  
Clinical Communication ◽  
Professional Experiences

Effective communication skills are important in the health care setting in order to develop rapport and trust with patients, provide reassurance, assess patients effectively and provide education in a way that patients easily understand (Candlin and Candlin, 2003). However with many nurses from culturally and linguistically diverse (CALD) backgrounds being recruited to fill the workforce shortfall in Australia, communication across cultures with the potential for miscommunication and ensuing risks to patient safety has gained increasing focus in recent years (Shakya and Horsefall, 2000; Chiang and Crickmore, 2009). This paper reports on the first phase of a study that examines intercultural nurse patient communication from the perspective of four Registered Nurses from CALD backgrounds working in Australia. Five interrelating themes that were derived from thematic analysis of semi-structured interviews are discussed. The central theme of ‘adjustment’ was identified as fundamental to the experiences of the RNs and this theme interrelated with each of the other themes that emerged: professional experiences with communication, ways of showing respect, displaying empathy, and vulnerability.

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