Comparing Patient to Provider Perceptions of Birth Trauma: What are We Missing?

backgroundTraumatic birth experiences are common and negatively affect the health and wellbeing of the birthing person. Interactions between patients and providers are an important risk factor for experiencing birth as traumatic. The current study investigated both patient and provider perceptions of birth.

methodsParticipants (N = 146) were recruited from a mother-baby postpartum recovery unit and asked about birth satisfaction, if they found their birth traumatic (using DSM-5 Diagnostic Criteria for PTSD), and if their providers debriefed with them post-birth. Providers (N = 95, including obstetricians and midwives) were also asked if the birth was traumatic.

resultsThere were 60 participants (41.1%) that experienced birth trauma, yet only two thirds received a debrief from their providers (n = 40, 66.7%). Only 65.9% of providers accurately endorsed their patient's birth as traumatic. Participants who endorsed birth trauma reported significantly lower satisfaction with their birth experience than those who did not (mean difference = 2.881, t = 7.217 (144), p<.001, CI [2.092, 3.670]). Most participants endorsed that they wanted to be asked whether their birth experience was traumatic, especially those that had experienced birth trauma (81.8%).

conclusionThere is a mismatch between how patients and providers are viewing the same birth experience. Obstetric providers are working with patients when they may be recovering from a traumatic event, creating an ideal opportunity for trauma-informed care. A universal workflow should include briefly discussing birth experiences, especially if the experience was traumatic, with future research focusing on patient and provider outcomes associated with improved conversations.