title: Australian midwives' experience of delivering a counselling intervention for women reporting a traumatic birth.
abstract: OBJECTIVE
  this paper describes midwives' experiences of learning new counselling skills and delivering a counselling intervention entitled 'Promoting Resilience on Mothers Emotions' (PRIME).
  
  
  METHODS
  a descriptive exploratory approach was used. Data collected included semi-structured interviews (n=42), midwife diary entries (18 pages) and web based postings (169 pages). Data were analysed using manual thematic method.
  
  
  METHODS
  the intervention study was conducted in two tertiary maternity hospitals in the Australian states of Queensland (QLD) and Western Australia (WA) during a 17 month period, from August 2008 to December 2009.
  
  
  METHODS
  midwives were employed as research assistants and trained to deliver a counselling intervention to women reporting a traumatic birth experience. Eighteen of a possible 20 Australian midwives participated in this study.
  
  
  METHODS
  PRIME is a midwife-led counselling intervention based on cognitive-behavioural principles and designed to ameliorate trauma symptoms. It is offered face-to-face within 72 hours of childbirth and by phone around six weeks post partum.
  
  
  RESULTS
  participating midwives felt confronted by the level of emotional distress some women suffered as a consequence of their birth experience. Four major themes were extracted: The challenges of learning to change; Working with women in a different way; Making a difference to women and me; and A challenge not about to be overcome.
  
  
  CONCLUSIONS
  the advanced counselling skills the midwives acquired improved their confidence to care for women distressed by their birthing experience and to personally manage stressful situations they encountered in practice.
authors: School of Nursing and Midwifery, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia; King Edward Memorial Hospital, Subiaco, Western Australia 6008, Australia. Electronic address: maree.reed@health.wa.gov.au.
authors: Maree
authors: M
authors: Reed
authors: School of Nursing and Midwifery, Maternity and Family, Centre for Health Practice Innovation (HPI), Griffith Health Institute, Griffith University, University Drive, Meadowbrook, Queensland 4131, Australia. Electronic address: j.fenwick@griffith.edu.au.
authors: Jennifer
authors: J
authors: Fenwick
authors: School of Nursing and Midwifery, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia; King Edward Memorial Hospital, Subiaco, Western Australia 6008, Australia. Electronic address: y.hauck@curtin.edu.au.
authors: Yvonne
authors: Y
authors: Hauck
authors: School of Nursing and Midwifery, Maternity and Family, Centre for Health Practice Innovation (HPI), Griffith Health Institute, Griffith University, University Drive, Meadowbrook, Queensland 4131, Australia. Electronic address: j.gamble@griffith.edu.au.
authors: Jenny
authors: J
authors: Gamble
authors: School of Nursing and Midwifery, Maternity and Family, Centre for Health Practice Innovation (HPI), Griffith Health Institute, Griffith University, University Drive, Meadowbrook, Queensland 4131, Australia. Electronic address: d.creedy@griffith.edu.au.
authors: Debra K
authors: DK
authors: Creedy
mesh_terms: D000328:Adult; D003376:Counseling; D004420:Dystocia / Q000451:nursing / Q000523:psychology*; D005260:Female; D006801:Humans; D007318:Inservice Training; D007407:Interviews as Topic; D008875:Middle Aged; D008880:Midwifery; D018743:Perinatal Care; D011247:Pregnancy; D011594:Psychometrics; D011793:Queensland; D014904:Western Australia
keywords: Birth trauma; Counselling; Midwives; Post partum distress