Perceptions of birth and wellbeing after birth debriefing among women who describe their birth as traumatic

Introduction: In Australia, birth debriefing (BD) practices have primarily focused on clinical PTSD-FC, often neglecting the needs of mothers who describe their birth as traumatic but do not meet PTSD-FC criteria. The cessation of routine BD has overlooked a significant cohort- mothers experiencing subjective birth trauma (SBT). Their perceptions and wellbeing during the postpartum period remain poorly understood, and the lack of targeted interventions limits options for these mothers. This study investigates the wellbeing and birth perceptions of Australian mothers one to three years postpartum, focusing on the impact of BD for both mothers with and without reported birth trauma and exploring alternative reflective interventions.

Method: Using a cross-sectional and correlational design, the study compared mothers with SBT to those without. Participants completed validated assessment tools: Childbirth Perception Scale, Self-Compassion Scale (Short Form), and Childbirth Experience Questionnaire (CEQ). Additional questions explored experiences with BD and other reflective practices.

Results: Of the 273 participants, 33.7 % reported traumatic birth experiences. A substantial proportion (80 %) expressed a desire to discuss their birth experiences, yet only 26 % underwent BD, and 64.4 % were unaware of its specifics. BD notably enhanced perceptions of birth for mothers without reported trauma but showed varied effectiveness for those with reported trauma. Writing interventions also emerged as a potentially beneficial alternative for processing birth experiences. Differences in emotional validation were noted between in-hospital and out-of-hospital debrief settings.

Discussion: Results highlight the need for person-centred, choice-based approaches in postnatal care, particularly for mothers experiencing SBT. While BD shows potential benefits for non-traumatised mothers, its varied effectiveness for those with trauma suggests a need for more tailored, trauma-informed debriefing approaches. Expanding access to diverse interventions that cater to all individuals and understanding BDs role in broader postnatal care could improve maternal outcomes.