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Nelson-Piercy C, Luyckx VA, Krawczyk P. Maternal critical care. Intensive Care Med 2024; 50:928-930. [PMID: 38844641 DOI: 10.1007/s00134-024-07443-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Accepted: 04/09/2024] [Indexed: 06/11/2024]
Affiliation(s)
| | - Valerie A Luyckx
- University Children's Hospital, University of Zurich, Zurich, Switzerland
| | - Paweł Krawczyk
- Department of Anesthesiology and Intensive Care, Jagiellonian University Medical College, Cracow, Poland
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2
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Suarez A, Yakupova V. Childbirth experiences of women with a history of physical, sexual, and child abuse: a cross-sectional study of 2,575 Russian women. BMC Pregnancy Childbirth 2024; 24:186. [PMID: 38459457 PMCID: PMC10921683 DOI: 10.1186/s12884-024-06369-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/24/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND A substantial number of women who subsequently become pregnant and give birth have a history of physical, sexual, and/or child abuse. This study investigated the associations of these types of traumas and their cumulative effect with childbirth experiences, namely, mode of birth, maternal and child complications during pregnancy/childbirth, preterm birth, medical procedures, and obstetric violence during labour. METHODS A group of Russian women (n = 2,575) who gave birth within the previous 12 months, completed a web-based survey, where they provided demographic information, details about their childbirth experiences, and a history of trauma. RESULTS Women with any type of past abuse were at higher risk for maternal complications during pregnancy/childbirth (exp(β) < 0.73, p < 0.010 for all). More specific to the type of trauma were associations of physical abuse with caesarean birth, child abuse with complications during pregnancy/childbirth for the baby, and physical and child abuse with obstetric violence (exp(β) < 0.54, p < 0.022 for all). There was a cumulative effect of trauma for all the outcomes except for medical procedures during childbirth and preterm birth. CONCLUSION This study provides insights into potential different individual effects of physical, sexual, and/or child abuse as well as their cumulative impact on the childbirth experiences. The robust findings about maternal complications during pregnancy/childbirth and obstetric violence highlight the importance of trauma-informed care, supportive policies, and interventions to create safe and empowering birthing environments that prioritise patient autonomy, dignity, and respectful communication.
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Affiliation(s)
- Anna Suarez
- Department of Psychology, Lomonosov Moscow State University, Mokhovaya St, 11/9, Moscow, 125009, Russia.
| | - Vera Yakupova
- Department of Psychology, Lomonosov Moscow State University, Mokhovaya St, 11/9, Moscow, 125009, Russia
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Jiang A, Perry T, Walker K, Burfoot A, Patterson L. Surgical sensation during caesarean section: a qualitative analysis. Int J Obstet Anesth 2024; 57:103935. [PMID: 37925355 DOI: 10.1016/j.ijoa.2023.103935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 08/13/2023] [Accepted: 10/02/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND Caesarean section (CS) is a major abdominal surgery performed usually on a young and healthy population under neuraxial anesthesia with little to no sedation. This creates a distinct surgical experience whereby patients are aware of the surgical process, physical sensations, and their environment. This study aimed to provide an in-depth descriptive assessment of subjective surgical experience during CS under regional anaesthesia. We expected the information gained would enhance our current understanding and better alleviate patient anxiety through informed counselling. METHODS This qualitative descriptive study was conducted at a Canadian academic centre. Twenty patients participated in semi-structured interviews within a week of CS, using an interview guide developed for this study. Patient medical records were reviewed to collect demographic and surgical information. Thematic analysis was conducted using an inductive approach to determine common themes. RESULTS Nine themes were identified. Five themes were identified in the category of surgical sensation and four themes were identified in the category of peri-operative education. CONCLUSIONS Patients commonly experienced pressure and movement sensations at varying intensity, and most did not experience pain. Environmental factors, including sounds and distraction by the newborn, affected perception of surgical sensation. Patients wish to receive pre-operative counselling regarding potential surgical sensations, as well as ongoing communication from their anaesthesiologist. These results can be used to guide informed discussions with patients and direct further investigation in this area.
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Affiliation(s)
- A Jiang
- Department of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Kingston, Ontario, Canada.
| | - T Perry
- Department of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | - K Walker
- Department of Sociology, Queen's University, Kingston, Ontario, Canada
| | - A Burfoot
- Department of Sociology, Queen's University, Kingston, Ontario, Canada
| | - L Patterson
- Department of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Kingston, Ontario, Canada
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Lathan EC, Britt A, Ravi M, Ash MJ, McAfee E, Wallace S, Johnson CB, Woods-Jaeger B, Powers A, Michopoulos V. WHEN REPRODUCTION IS NO LONGER AUTONOMOUS: FEELING RESPECTED BY MATERNITY CARE PROVIDERS MODERATES THE ASSOCIATION BETWEEN AUTONOMY IN DECISION MAKING AND BIRTH-RELATED PTSD SYMPTOMS IN A COMMUNITY SAMPLE OF POSTPARTUM BLACK WOMEN. J Trauma Dissociation 2023; 24:520-537. [PMID: 37233983 PMCID: PMC10330569 DOI: 10.1080/15299732.2023.2212406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 04/17/2023] [Indexed: 05/27/2023]
Abstract
Black individuals are at particularly high risk for birth-related posttraumatic stress disorder (PTSD) symptoms, in part due to a lack of opportunity to lead maternity care decisions. Maternal care providers need evidence-based ways to reduce pregnant persons' risk for birth-related PTSD symptoms despite reduced autonomy in decision making resulting from heightened restrictions on reproductive rights. We investigated whether a potential relation between autonomy in decision making and birth-related PTSD symptoms would be moderated by being mistreated or feeling respected by maternity care providers in a community sample of Black women (N = 52; Mage = 28.2 years, SDage = 5.7 years) seeking maternity care at a public hospital in the southeastern United States. At six weeks postpartum, participants completed measures assessing autonomy in decision making, current birth-related PTSD symptoms, number of mistreatment events, and feelings of respect from providers during pregnancy, childbirth, and the postpartum period. Autonomy in decision making was negatively correlated with birth-related PTSD symptoms, r=-.43, p < .01. An interaction between autonomy in decision making and mistreatment by providers was trending toward significance, B=-.23, SE=.14, p = .10. Autonomy in decision making and feeling respected by maternity care provider interacted to predict birth-related PTSD symptoms, B = .05, SE=.01, p < .01. Feeling respected by providers may buffer against the negative effects of lack of autonomy in decision making on birth-related PTSD symptoms, highlighting the importance of providers' ability to convey respect to pregnant patients when they cannot lead care decisions.
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Affiliation(s)
- Emma C. Lathan
- Dept of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Abby Britt
- Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, GA, USA
| | - Meghna Ravi
- Dept of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Marcia J. Ash
- Dept of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Elizabeth McAfee
- Dept of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Shimarith Wallace
- Dept of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Colin B. Johnson
- Dept of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Briana Woods-Jaeger
- Dept of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Abigail Powers
- Dept of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Vasiliki Michopoulos
- Dept of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
- Emory National Primate Research Center, Atlanta, GA, USA
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Suarez A, Yakupova V. Past Traumatic Life Events, Postpartum PTSD, and the Role of Labor Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6048. [PMID: 37297652 PMCID: PMC10252538 DOI: 10.3390/ijerph20116048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/02/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023]
Abstract
The aim of this study was to investigate the association of postpartum post-traumatic stress disorder (PP-PTSD) symptoms and subjective rates of traumatic birth experience with past traumatic life events (physical and sexual assault, child abuse, perinatal loss, previous traumatic birth experience, and the cumulative traumatic experience). A sample of Russian women (n = 2579) who gave birth within the previous 12 months, filled in a web-based survey, where they reported demographic and obstetric characteristics and past traumatic experiences, evaluated their birth experience (0 = not traumatic, 10 = extremely traumatic), and completed the City Birth Trauma Scale (CBiTS). We found that PP-PTSD symptoms were higher among women who previously experienced physical (F = 22.02, p < 0.001) and sexual (F = 15.98, p < 0.001) assault and child abuse (F = 69.25, p < 0.001), with only associations with child abuse (F = 21.14, p < 0.001) remaining significant for subjective rates of traumatic birth experience. Perinatal loss and previous traumatic birth showed moderate but inconsistent effects. Support during labor did not have a buffering effect for participants with past traumatic experiences but showed a universally protective effect against PP-PTSD. Trauma-informed practices and allowing women to have a supportive birth team of choice during childbirth are promising avenues to minimize the incidence of PP-PTSD and improve the childbirth experience for all women.
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Affiliation(s)
- Anna Suarez
- Department of Psychology, Lomonosov Moscow State University, Moscow 119991, Russia;
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Gökçe İsbir G, İnci F, Kömürcü Akik B, Abreu W, Thomson G. Birth-related PTSD symptoms and related factors following preterm childbirth in Turkey. CURRENT PSYCHOLOGY 2022; 42:1-12. [PMID: 36340892 PMCID: PMC9616695 DOI: 10.1007/s12144-022-03805-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2022] [Indexed: 11/03/2022]
Abstract
Objective: To examine factors associated with birth-related post-traumatic stress disorder (PTSD) among women who had preterm birth in their last pregnancy in Turkey.Methods: 304 women were asked to report sociodemographic factors, perinatal factors, birth-related factors, preterm birth/premature infant characteristics, and social support factors and PTSD symptoms. Data were collected using online surveys between November 2020 and February 2021. Hierarchical multiple linear regression was used. Results: The prevalence of birth-related PTSD symptoms following preterm birth was 71.1%. Older age, the woman being positively affected by her own mother's birth experience, not having traumatic experience in pregnancy and in the postnatal period, lower stress level after traumatic events experienced during birth, not feeling that their life/physical integrity was at risk during birth, having amniotomy, feeling psychologically well after childbirth, not being negatively affected by witnessing other parents' happy moments with their babies in friend/family groups, the absence of infant illness and mother's reporting higher positive interactions with healthcare team were associated with decreased likelihood of birth-related PTSD. Except for age and traumatic event in the postnatal period, all the variables explained 43% of the variance with a small effect size (f 2 = 0.04). Stress level after the traumatic events experienced during labor was the strongest predictor of birth-related PTSD symptoms (β = 0.33). Conclusion: Wellbeing of mother and baby, facilitating interventions at labor, and positive communication with the healthcare team was associated with lower birth-related PTSD symptoms. The study findings highlighted on birth-related PTSD symptoms in mothers of preterm infants in Turkey.
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Affiliation(s)
- Gözde Gökçe İsbir
- Midwifery Department, School of Health, Mersin University, Mersin, Turkey
| | - Figen İnci
- Psychiatric Nursing Department, Faculty of Zübeyde Hanım Health Sciences, Niğde Ömer Halisdemir University, Niğde, Turkey
| | - Burcu Kömürcü Akik
- Department of Psychology, Faculty of Languages and History-Geography, Ankara University, Ankara, Turkey
| | - Wilson Abreu
- School of Nursing and Research Centre, CINTESIS/ESEP (Center for Research in Health Technologies and Services), University of Porto, Porto, Portugal
| | - Gill Thomson
- Maternal and Infant Nutrition and Nurture Unit (MAINN), School of Health, University of Central Lancashire, Preston, UK
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Bishop DG, Lucas DN. If it isn’t written down, then it didn’t happen: documentation in obstetric anaesthesia. SOUTHERN AFRICAN JOURNAL OF ANAESTHESIA AND ANALGESIA 2022. [DOI: 10.36303/sajaa.2022.28.4.2845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- DG Bishop
- Perioperative Research Group, Department of Anaesthetics, Critical Care and Pain Management, University of KwaZulu-Natal,
South Africa
| | - DN Lucas
- Department of Anaesthesia, London North West University Healthcare NHS Trust,
United Kingdom
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Molgora S, Campo E, Carones MB, Ferrazzi E, Saita E, Facchin F. Predictors of Women’s Childbirth Experience: A Prospective Longitudinal Study on Italian New Mothers. INTERNATIONAL JOURNAL OF CHILDBIRTH 2022. [DOI: 10.1891/ijc-2021-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUNDWomen’s memories of their childbirth experience tend to remain unchanged over time. This experience can be influenced by obstetric factors as well as by sociodemographic and psychological variables.OBJECTIVETo examine whether women’s perceived childbirth experience changes over time; to identify the predictors (obstetric, sociodemographic, and psychological variables) of this experience immediately after delivery and after 3 months.METHODSThis prospective longitudinal study comprised two hundred and twenty-one Italian women who completed a self-report questionnaire at two assessment points: immediately (1–3 days) after birth (Time 1) and 3 months postpartum (Time 2). At Time 1, the questionnaire included some questions on sociodemographic, psychological, and obstetric information, and the Wijma Delivery Experience Questionnaire (WDEQ(B); at Time 2 women compiled again the WDEQ(B).RESULTSRepeated measures ANOVA revealed that the childbirth experience did not change from Time 1 to Time 2. However, predictors of this experience were different between Time 1 and Time 2: at Time 1, the childbirth experience (WDEQ(B)_t1) was significantly predicted nly by type of cesarean section; at Time 2, the childbirth experience (WDEQ(B)_t2) was significantly predicted by WDEQ(B)_t1, history of psychological disorders, and type of conception.DISCUSSIONSOur findings enhance the understanding of the main predictors of a woman’s childbirth experience. Identifying areas of vulnerability is important for clinical practice, as well as for developing maternal health policies to improve women’s birth experiences, postpartum well-being, and the baby’s development.
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Abstract
The integration of trauma-informed care practices into the care of obstetric patients requires an understanding of psychological trauma, its impact on this population, and how trauma-informed care can be adapted to improve outcomes for those patients with a previous history of trauma or for those that experience peripartum trauma. System-based changes to policies, protocols, and practices are needed to achieve sustainable change. Maternal morbidity and mortality that result from trauma-related and other mental health conditions in the peripartum period are significant. Innovative approaches to the prevention of negative birth experiences and retraumatization during labor and delivery are needed.
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Affiliation(s)
- Tracey M Vogel
- Department of Anesthesiology, West Penn Hospital/Allegheny Health Network, 4800 Friendship Avenue, Pittsburgh, PA 15224, USA.
| | - Erica Coffin
- Obstetric Anesthesia, Department of Anesthesiology, West Penn Hospital/Allegheny Health Network, 4800 Friendship Avenue, Pittsburgh, PA 15224, USA. https://twitter.com/coffin_erica
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Vogel TM. Unique Pain Management Needs for Pregnant Women with Pre-existing PTSD and Other Mental Health Disorders. CURRENT ANESTHESIOLOGY REPORTS 2021. [DOI: 10.1007/s40140-020-00430-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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