Ignite Creation Date:
2024-05-06 @ 7:58 PM
Last Modification Date:
2024-10-26 @ 3:17 PM
Study NCT ID:
NCT06204757
Status:
ACTIVE_NOT_RECRUITING
Last Update Posted:
2024-01-12
First Post:
2023-12-15
Brief Title:
Study of the Identification of Childbirth Trauma in the Birth Room by Midwives
Sponsor:
Centre Hospitalier Universitaire de Besancon
Organization:
Centre Hospitalier Universitaire de Besancon
Study Overview
Official Title:
Study of the Identification of Childbirth Trauma in the Birth Room by Midwives
Status:
ACTIVE_NOT_RECRUITING
Status Verified Date:
2024-09
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
TOPASE
Brief Summary:
Childbirth is a critical moment in this perinatal period with high unpredictability and risks of medical complications for the mother and child It can be experienced as a traumatic experience for the woman
The consequences of a traumatic childbirth are numerous psychiatric consequences for the mother with increased risk of post-traumatic stress syndrome of postpartum depression decompensation of an old psychiatric illness suicide addictive disorders consequences on interactions early mother-baby interactions are of poorer quality if the women have a negative experience of their birth
Very few studies have focused on the early detection of traumatic childbirth on the day of it These evaluations only take into account the womens experience of their childbirth
The systematization of a screening questionnaire for all deliveries would help to detect obvious traumatic deliveries but also to detect traumatic experiences when objectively the delivery occurs without obstetric complications
This is why the objective of our study is to evaluate the perception of traumatic births by midwives
The consequences of a traumatic childbirth are numerous psychiatric consequences for the mother with increased risk of post-traumatic stress syndrome of postpartum depression decompensation of an old psychiatric illness suicide addictive disorders consequences on interactions early mother-baby interactions are of poorer quality if the women have a negative experience of their birth
Very few studies have focused on the early detection of traumatic childbirth on the day of it These evaluations only take into account the womens experience of their childbirth
The systematization of a screening questionnaire for all deliveries would help to detect obvious traumatic deliveries but also to detect traumatic experiences when objectively the delivery occurs without obstetric complications
This is why the objective of our study is to evaluate the perception of traumatic births by midwives
Detailed Description:
In a womans life the perinatal period is a phase of vulnerability at risk of psychiatric complications risk of decompensation of an existing psychiatric illness depression bipolar disorder psychosis anxiety disorder and triggering of a pathology de novo Childbirth is a critical moment in this perinatal period with high unpredictability and risks of medical complications for the mother and child It can be experienced as a traumatic experience for the woman In France 167 of women present major depressive symptoms 2 months after giving birth National Institute of Health and Medical Research 2021 Suicide is one of the two leading causes of maternal mortality up to 1 year postpartum with approximately 1 suicide per month approximately 134 of maternal deaths the vast majority of which 913 is considered potentially preventable National Institute of Health and Medical Research 2021b
The data in the literature are still insufficient and lacking in homogeneity Among the most relevant an Australian study from 2014 found a traumatic childbirth experience in 143 of women 890 completed questionnaires Boorman et al 2014 In recent studies the rate of negative childbirth experiences ranges from 5 to 21 of women Henriksen et al 2017 Nystedt Hildingsson 2018 Sigurdardottir et al 2017 Smarandache et al 2016 The consequences of a traumatic childbirth are numerous
Psychiatric consequences for the mother with increased risk of post-traumatic stress syndrome of postpartum depression decompensation of an old psychiatric illness suicide National Institute of Health and Medical Research 2021a Orsolini et al 2016 addictive disorders
Consequences on interactions early mother-baby interactions first 4 months postpartum are of poorer quality if the women have a negative experience of their birth
Traumatic childbirth has long-term repercussions on identity relationships with others and adherence to care with more medical wandering
It is therefore important to treat the trauma of childbirth early to reduce the severity and duration of its complications Marianne Kédia Sabouraud-Séguin 2020
If it is not identified in the maternity ward women will often not talk about the trauma or will talk about it after their next pregnancy As mentioned above the risk of depression and suicide is higher
If it is identified on the day of the trauma psychological or psychiatric support can be started during the stay in the maternity ward by sharing this experience recognized by the healthcare teams A single debriefing interview after a trauma is not enough to reduce the risk of complications but allows an alliance to be established to implement care Sabouraud-Séguin 2020
The recognition of traumatic childbirth is recent and teams are still insufficiently aware of the consequences and poorly trained in the systematization of recommendations Screening for traumatic childbirth should be carried out throughout the perinatal period Before childbirth during pregnancy monitoring caregivers identify patients with vulnerabilities such as a history of trauma complicated deliveries or vulnerability These women will be more at risk of having a negative experience of their childbirth Ayers et al 2016 In the delivery room the teams identify obstetric situations at risk of trauma instrument cesarean section somatic complications for the mother such as hemorrhages and somatic complications for the child such as situations requiring neonatal resuscitation and observe the reactions of the patient During the stay in the maternity ward the teams question the mothers experience of childbirth observe their behavior and first interactions Symptoms that are part of the state of acute stress should alert you intrusive symptoms negative mood dissociative symptoms avoidance symptoms and arousal symptoms American Psychiatric Association et al 2015 After leaving the maternity ward the woman has numerous follow-up appointments for herself and her baby including the post-natal appointment These moments of discussion are key moments for screening for traumatic symptoms acute stress and post-traumatic stress syndrome and depressive symptoms
Very few studies have focused on the early detection of traumatic childbirth on the day of it These evaluations only take into account the womens experience of their childbirth Two self-questionnaires were validated Childbirth Experience Evaluation Questionnaire QEVA Carquillat et al 2017 Chabbert et al 2021 Peritraumatic Distress Inventory PDI which measures peri-traumatic distress without being specific to an event it is therefore not specialized for childbirth Professional Space Training Info-Trauma nd Jehel et al 2005
The limits linked to self-questionnaires in a traumatic context and the impact of avoidance syndrome women who have experienced a traumatic childbirth are more likely to avoid thinking about events places people linked to the trauma
To our knowledge no tool has been developed to assess the perception of traumatic births by midwives
Midwives have an essential role during childbirth from an obstetrical point of view but also from a psychological point of view They are present throughout the birth labor expulsion delivery and accompany the woman through her emotions her doubts and her requests with a common goal the smooth running of the birth However they observe the entire course of the birth with its complications and the reactions of the women A hetero-assessment questionnaire so that the trauma of childbirth can be assessed by midwives without needing the woman to recount her experience would be useful for screening The systematization of a screening questionnaire for all deliveries would help to detect obvious traumatic deliveries for example during code red cesarean sections but also to detect traumatic experiences when objectively the delivery occurs without obstetric complications
In addition the systematic questionnaire would make it possible to obtain the midwives observations which are not always transmitted in their entirety to the maternity team when the emotional experience has been too intense
The objective of our study is to evaluate the perception of traumatic births by midwives
The research hypothesis is that midwives can identify some indicators of birth trauma during childbirth and contribute to screening for traumatic birth
The data in the literature are still insufficient and lacking in homogeneity Among the most relevant an Australian study from 2014 found a traumatic childbirth experience in 143 of women 890 completed questionnaires Boorman et al 2014 In recent studies the rate of negative childbirth experiences ranges from 5 to 21 of women Henriksen et al 2017 Nystedt Hildingsson 2018 Sigurdardottir et al 2017 Smarandache et al 2016 The consequences of a traumatic childbirth are numerous
Psychiatric consequences for the mother with increased risk of post-traumatic stress syndrome of postpartum depression decompensation of an old psychiatric illness suicide National Institute of Health and Medical Research 2021a Orsolini et al 2016 addictive disorders
Consequences on interactions early mother-baby interactions first 4 months postpartum are of poorer quality if the women have a negative experience of their birth
Traumatic childbirth has long-term repercussions on identity relationships with others and adherence to care with more medical wandering
It is therefore important to treat the trauma of childbirth early to reduce the severity and duration of its complications Marianne Kédia Sabouraud-Séguin 2020
If it is not identified in the maternity ward women will often not talk about the trauma or will talk about it after their next pregnancy As mentioned above the risk of depression and suicide is higher
If it is identified on the day of the trauma psychological or psychiatric support can be started during the stay in the maternity ward by sharing this experience recognized by the healthcare teams A single debriefing interview after a trauma is not enough to reduce the risk of complications but allows an alliance to be established to implement care Sabouraud-Séguin 2020
The recognition of traumatic childbirth is recent and teams are still insufficiently aware of the consequences and poorly trained in the systematization of recommendations Screening for traumatic childbirth should be carried out throughout the perinatal period Before childbirth during pregnancy monitoring caregivers identify patients with vulnerabilities such as a history of trauma complicated deliveries or vulnerability These women will be more at risk of having a negative experience of their childbirth Ayers et al 2016 In the delivery room the teams identify obstetric situations at risk of trauma instrument cesarean section somatic complications for the mother such as hemorrhages and somatic complications for the child such as situations requiring neonatal resuscitation and observe the reactions of the patient During the stay in the maternity ward the teams question the mothers experience of childbirth observe their behavior and first interactions Symptoms that are part of the state of acute stress should alert you intrusive symptoms negative mood dissociative symptoms avoidance symptoms and arousal symptoms American Psychiatric Association et al 2015 After leaving the maternity ward the woman has numerous follow-up appointments for herself and her baby including the post-natal appointment These moments of discussion are key moments for screening for traumatic symptoms acute stress and post-traumatic stress syndrome and depressive symptoms
Very few studies have focused on the early detection of traumatic childbirth on the day of it These evaluations only take into account the womens experience of their childbirth Two self-questionnaires were validated Childbirth Experience Evaluation Questionnaire QEVA Carquillat et al 2017 Chabbert et al 2021 Peritraumatic Distress Inventory PDI which measures peri-traumatic distress without being specific to an event it is therefore not specialized for childbirth Professional Space Training Info-Trauma nd Jehel et al 2005
The limits linked to self-questionnaires in a traumatic context and the impact of avoidance syndrome women who have experienced a traumatic childbirth are more likely to avoid thinking about events places people linked to the trauma
To our knowledge no tool has been developed to assess the perception of traumatic births by midwives
Midwives have an essential role during childbirth from an obstetrical point of view but also from a psychological point of view They are present throughout the birth labor expulsion delivery and accompany the woman through her emotions her doubts and her requests with a common goal the smooth running of the birth However they observe the entire course of the birth with its complications and the reactions of the women A hetero-assessment questionnaire so that the trauma of childbirth can be assessed by midwives without needing the woman to recount her experience would be useful for screening The systematization of a screening questionnaire for all deliveries would help to detect obvious traumatic deliveries for example during code red cesarean sections but also to detect traumatic experiences when objectively the delivery occurs without obstetric complications
In addition the systematic questionnaire would make it possible to obtain the midwives observations which are not always transmitted in their entirety to the maternity team when the emotional experience has been too intense
The objective of our study is to evaluate the perception of traumatic births by midwives
The research hypothesis is that midwives can identify some indicators of birth trauma during childbirth and contribute to screening for traumatic birth
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None