Childbirth Related Post-Traumatic Stress Disorder and Childbirth Trauma: A Systematic Review of Available Primary Antenatal Intervention

Abstract

Background: Growing evidence highlights maternal risk factors that can increase the likelihood of traumatic childbirth experience. Yet little is known about the availability of primary antenatal intervention for childbirth trauma to facilitate optimal maternal and infant outcomes. The aim of this study was to conduct a systematic review of the literature and empirical evidence to identify antenatal interventions and their effectiveness for treatment of childbirth trauma, post-traumatic stress disorder (PTSD), subthreshold PTSD, or post-traumatic stress (PTS) from childbirth. Methods: Four databases were accessed: PUBMED, CINAHL, ProQuest, and EBSCOHOST. PRISMA guidelines were followed for screening and reporting. Inclusion criteria were as follows: (1) peer reviewed articles; (2) samples of pregnant women; (3) published in English; (4) measure of PTSD, PTSD symptoms, PTS or fear of childbirth; (5) variable of childbirth trauma or childbirth experience; (6) antenatal intervention; and (7) human studies. Results: We identified 2034 articles, with 12 articles in the final sample. The most common antenatal intervention in four studies was childbirth plans, which were associated with an increase in positive childbirth experience, childbirth control, mastery, and participation, as well as increased self-efficacy and reduced PTSD symptoms (p < 0.01). Other interventions included antenatal counseling and psychoeducation; eye movement desensitization and reprocessing; counseling; haptotherapy; trauma-informed care; cognitive behavioral therapy; and hypnosis for childbirth trauma. Conclusions: Methodological limitations as well as a lack of inclusion of women with perinatal mental health difficulties represent gaps in knowledge. Findings suggest promising evidence for the implementation of antenatal interventions in clinical and hospital contexts to treat childbirth trauma.