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ABSTRACT
Objective: Review primary research regarding PTSD Post-Childbirth (PTSD-PC) that focussed on Quality of Provider Interaction (QPI) from the perspective of women who developed PTSD-PC, or midwives.
Background: Up to 45% of women find childbirth traumatic. PTSD-PC develops in 4% of women (18% in high-risk groups). Women’s subjective experiences of childbirth are the most important risk factor in the development of PTSD-PC, with perceived QPI being key.
Methods: A systematic search was performed for PTSD-PC literature. Reviewed papers focussed on either women’s subjective childbirth experiences, particularly QPI, or midwives’ perspectives on QPI. Study quality was assessed using the Critical Appraisal Skills Programme (CASP) tools, and a narrative synthesis of findings produced.
Results: Fourteen studies were included. Three features of QPI contribute towards developing PTSD-PC: interpersonal factors; midwifery care factors; and lack of support.
Conclusion: QPI is a significant factor in the development of PTSD-PC and the identified key features of QPI have potential to be modified by midwives. The development of guidelines for midwives should be grounded on evidence highlighted in this review, along with further high-quality qualitative research exploring QPI from the perspective of women with PTSD-PC, but also midwives’ knowledge and needs regarding their role within QPI.
Disclosure statement
No potential conflict of interest was reported by the authors.
Notes
1. These include DSM-III (APA, Citation1980), DSM-III-R (APA, Citation1987), DSM-IV (APA, Citation1994), DSM-IV-R (APA, Citation2000) and DSM-V (APA, Citation2013). Note the International Classification of Diseases (ICD) criteria for PTSD were not referenced in this review, consistent with all identified research on PTSD-PC.