Shattered Expectations: The experience of care provider interaction from the perspectives of women with Post Traumatic Stress Disorder Post Childbirth, and midwives. An Interpretative Phenomenological Analysis.

Background: Post Traumatic Stress Disorder-Post Childbirth (PTSD-PC) has important implications for mothers, children, families, and healthcare services. Interpersonal factors are the strongest predictor for the development of PTSD-PC, with the woman’s subjective experience of Quality of Provider Interaction (QPI) being a significantly associated factor. Within PTSD-PC research, no studies were identified that explored midwives’ experiences of interacting with women during the provision of care, nor any qualitative studies that specifically investigated women’s experiences of QPI.Aims:To explore the lived experience of QPI during childbirth in women who have developed PTSD following this childbirth event. To explore midwives’ lived experiences of interacting with women during maternity care provision. To inform appropriate recommendations for the education and development of midwives.Methods: Six women who had developed PTSD-PC were recruited from across three regions in Scotland. Six intrapartum midwives were recruited from one NHS region in Scotland. In-depth, semi-structured interviews were carried out for all 12 informants. These interviews were audio recorded and transcribed verbatim. The interview data was analysed using Interpretative Phenomenological Analysis (IPA).Results:For the women informants, master themes emerged from their lived experiences of QPI: Being with me; Shattered expectations; and Whose power? For the midwife informants, master themes emerged from their lived experience of interacting with women during care provision: Being with women, what it is all about; What we have to work within; and Enable me as a midwife.Conclusion: This study enables deeper understanding of both sides of the story relating to QPI. While experiences are subjective, understanding the way women who develop PTSD-PC perceived QPI, alongside the challenges that midwives experience in terms of optimising QPI, serves to highlight the issues that may require further attention within maternity services. This knowledge and understanding will therefore inform future research, midwifery education and practice, as well as policy development