Instead, various terms such as “birth/childbirth trauma,” “traumatic birth/childbirth,” “traumatic birth/childbirth experience,” or “psychological birth/childbirth trauma” are used, with almost the same meaning. Adding to the dilemma is the fact that there is no consistent definition, terminology, or detailed description of this concept in the literature. An international knowledge mapping exercise aimed at examining policies, services, and training provisions for women following traumatic birth showed that of the 18 European countries that participated, only the Netherlands has national policies on screening, treatment, and prevention of traumatic birth experiences ( Thomson et al., 2021). Regrettably, not enough attention has been paid to the psychological birth trauma itself, and more attention seems to be focused on the diagnosable postpartum psychological problems, such as postpartum PTSD mentioned above. Another study investigated the impact of unaccompanied birth caused by COVID-19-related visiting bans on mothers’ mental health, and found that mothers who gave birth unaccompanied had higher psychological distress than those who gave birth accompanied ( Oddo-Sommerfeld et al., 2022). A study conducted in the United States confirmed that women who gave birth during the outbreak of COVID-19 experienced more traumatic births and subsequent mother-infant bonding problems than those who gave birth before the pandemic ( Mayopoulos et al., 2021). Notably, the ongoing COVID-19 seems to have made this phenomenon more complicated. Some studies have focused on investigating the risk factors of psychological birth trauma, and multiple factors have been found, including some objective factors, such as preterm delivery ( Chabbert et al., 2021 Sommerlad et al., 2021), as well as some subjective factors, such as women feeling disrespected by healthcare professionals during birth ( Zhang et al., 2020 McKelvin et al., 2021 Watson et al., 2021 Liu et al., 2022).
This means that more postpartum women who have experienced psychological trauma are not reaching the threshold of PTSD and are therefore unidentified, but they are struggling with the trauma. A meta-analysis suggested that 4% of postpartum women in community samples developed PTSD following a traumatic birth experience, compared with 18.5% in high-risk samples (such as women with complications of pregnancy or childbirth) ( Yildiz et al., 2017). These symptoms can appear directly after experiencing a traumatic event, but can also occur later in life ( American Psychiatric Association, 2000). According to DSM-IV criteria, PTSD is categorized as a disorder related to trauma and stress, which is mainly manifested in four symptom clusters: re-experience, avoidance, hyperarousal, and negative cognition and mood, and these symptoms should exist for more than a month ( American Psychiatric Association, 2000). The further impact of psychological birth trauma is associated with post-traumatic stress disorder (PTSD) ( Taghizadeh et al., 2013 Türkmen et al., 2020 McKelvin et al., 2021), a widely known term. These impacts appear to be centered on the poor mental health of women themselves ( Beck, 2006 Taghizadeh et al., 2013), and then expand like ripples, affecting mother-infant relationships ( Taghizadeh et al., 2013 Beck and Watson, 2019), breastfeeding behavior ( Beck and Watson, 2008 Fenech and Thomson, 2014), marital relationships ( Taghizadeh et al., 2013 Fenech and Thomson, 2014), and future reproductive decisions ( Gottvall and Waldenström, 2002 Taghizadeh et al., 2013 Holopainen et al., 2020), etc. Professor Beck used the word “ripple effect” to describe the negative impacts of psychological birth trauma ( Beck, 2015).
Studies indicated that the incidence of traumatic birth ranges from 20 to 68.6 percent in different countries ( Uotila et al., 2005 Türkmen et al., 2020 Bay and Sayiner, 2021). Negative birth experiences can even cause terrible psychological trauma to women ( Fenech and Thomson, 2015 Shorey and Wong, 2022).
Not only does it involve huge physical changes, but it is also accompanied by significant psychological fluctuations ( Fenech and Thomson, 2015 Shorey and Wong, 2022). Childbirth, a major event in a woman’s life, is of a profound and complex nature ( Shorey and Wong, 2022).
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