Grieving Though Grateful: Reconciling the Traumatic and Disappointing Birth Experience
Purpose*
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When a woman experiences a
traumatic or disappointing birth, there often exists an emotional
dichotomy between gratefulness for the child and grief toward the the
experience. This presentation describes characteristics that contribute
to traumatic birth and resources for the PMH nurse to aid in prevention,
diagnosis, treatment, and collaboration.
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Summary of evidence*
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Though up to 30% of women
world-wide experience traumatic birth, a review of the literature
reveals a paucity of research, and the DSM-5 lacks discussion in the sections
on perinatal mood disorders, trauma and stress-related disorders,
or bereavement.
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Description of practice or
protocol*
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Traumatic birth may be missed or
mistaken for other postpartum mood disorders by clinicians, and
under-reported by mothers due to stigma. Platitudes such as "all that
matters is a healthy baby" minimize and invalidate the mother's grief
toward the experience and contribute to feelings of guilt, anger,
helplessness, or diminished self-esteem.
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Validation of Evidence / Method of
Evaluation*
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Factors including psychiatric
history, unplanned or emergent obstetric intervention, pain, loss of control,
and lack of interpersonal support contribute to negative birth experiences,
and put the mother at risk for ineffective maternal role attainment and
mental health disorders.
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Relevance to PMH Nursing / Results*
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A comprehensive
understanding of traumatic birth provides the PMH nurse a foundation
for enhanced assessment, intervention, integrative strategies, and
interdisciplinary collaboration to help women at risk for or experienced
traumatic birth.
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Future implications*
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Birth is not a mearly a means to
an end, but an experience independent of the outcome.
Understanding the risk factors, characteristics, and resources results
in refined diagnosis, effective treatment planning, and the opportunity to
build connections with peer obstetric clinicians.
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