A Thematic Analysis of Narratives About Birth Satisfaction and Health Awareness From Postnatal Women Who Have High and Low Trauma Scores on thePosttraumatic Stress Disorder Checklist

Abstract

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 labor, with continuity, choice, support, and control, alongside postnatal health follow-up may improve birth satisfaction and reduce the incidence of PP-PTSD.CONCLUSION:To increase birth satisfaction and reduce trauma, maternity care providers must be supported to prioritize high-quality psychological care to women during labor, 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.