Approach to postpartum women with psychological trauma during childbirth – Case study

Abstract

Introduction: The experience of childbirth is unique for each woman, and leaves a mark of great importance on her life. However, this event can be the trigger for the appearance of various psychological traumas. Psychological trauma during childbirth is an international public health problem, reported by around 45% of women, and which can have several repercussions on the quality of life of the mother, baby and family. Mothers who have experienced birth trauma have greater difficulty breastfeeding, establishing bonds with their baby, report changes in their sexual life and have low self-esteem. After a traumatic birth experience, women are at greater risk of experiencing a new trauma or developing a fear of childbirth. According to the specialist in maternal health and obstetric nursing competency regulations, intervention in women with psychological birth trauma is involved in the different areas of activity of this profession, which is why studying this topic becomes relevant. Objectives: Systematize knowledge about diagnosis, risk factors and interventions in psychological trauma during childbirth, based on scientific evidence. Methodology: A literature review was used as a methodology for this work, supporting the learning strategy based on the resolution of a case study - Case-Based-Learning. The information on the clinical case in question was obtained through an interview with the user and subsequent consultation of the clinical file with her prior authorization. Confidentiality was guaranteed at all times, and consent was given to expose this case. Results: From the analysis of the clinical case, the diagnosis of psychological trauma during childbirth seems to be the most likely diagnosis. It would therefore be essential to confirm the diagnosis through the application of an assessment scale that would allow for a differential diagnosis with other postpartum psychoemotional changes. The use of a Postnatal Debriefing technique is considered very effective in addressing the psychological trauma resulting from childbirth, both for women and the health professionals who accompany them. Debriefing is generally carried out a few days after birth and in the presence of a healthcare professional (usually a Midwife), who may or may not have been present at the birth, where clinical recordsare reviewed and discussed, and the “step by step” of the practices that occurred. Shared decision-making, good communication, informed consent, and ongoing positive support during birth have the potential to reduce psychological morbidity after birth. Conclusions: The obstetric nursing expertise stands out, both in prevention and in the assessment, diagnosis and referral of women with psychological birth trauma. These are the health professionals who have the most contact with women during labor and postpartum, they have qualified knowledge combined with a high degree of empathy, and therefore have a prominent role in caring for women, namely in terms of mental health, during the reproductive cycle.