title: Emotions and support needs following a distressing birth: Scoping study with pregnant multigravida women in North-West England.
abstract: OBJECTIVE
  to identify the emotional and support needs of pregnant multigravida women who have experienced adverse responses associated with a previous childbirth experience.
  
  
  METHODS
  four maternity hospitals in North-West England.
  
  
  METHODS
  100 surveys were distributed at an anomaly scan clinic in each of four maternity hospitals (total n=400). The survey included an adapted version of a Post-Traumatic Stress Disorder Symptom Scale to explore trauma responses at two broad time points: (a) following a previous birth and (b) during the current pregnancy. Participants were also asked about the optimal time to receive support post-birth, and the type and provider of support they had accessed/would have liked to access. Descriptive and inferential statistics were undertaken on the quantitative data. The qualitative data were analysed using a basic thematic approach.
  
  
  METHODS
  multigravida pregnant women aged 18+ years.
  
  
  RESULTS
  the overall response rate was 28% (n=112); 43% (n=46) of the women had experienced negative/trauma responses associated with a previous birth, 74% of whom (n=34) continued/re-experienced adverse responses in their current pregnancy. Most commonly reported trauma responses were difficulties in recalling the previous birth(s), avoiding memories associated with it, and the distress associated with these memories when they were recalled. Approximately 54% (n=25) had received some form of support post-birth, and variations in preferred timing of postnatal support provision were reported. Information on available support and opportunities to discuss the birth with a maternity professional were identified most frequently as preferred support options.
  
  
  CONCLUSIONS
  women's views about what might work should form the basis for effectiveness studies in this area. Among the participants in this study there was evidence of unmet support needs relating to negative or traumatic responses to a previous birth. The range of preferred timing and types of support indicate that flexible needs-based support options should be provided. Further research should assess if these findings are reinforced in a more diverse sample with a higher response rate.
authors.affiliation: Maternal and Infant Nutrition & Nurture Unit (MAINN), University of Central Lancashire, Preston, Lancashire PR1 2HE, United Kingdom. Electronic address: gthomson@uclan.ac.uk.
authors.forename: Gill
authors.initials: G
authors.lastname: Thomson
authors.affiliation: Research in Childbirth and Health Unit (ReaCH), University of Central Lancashire, Preston, Lancashire, England PR1 2HE, United Kingdom. Electronic address: sdowne@uclan.ac.uk.
authors.forename: Soo
authors.initials: S
authors.lastname: Downe
mesh_terms: D000328:Adult; D004644:Emotions; D004739:England; D005260:Female; D020073:Gravidity; D006801:Humans; D008875:Middle Aged; D036801:Parturition / Q000523:psychology*; D011181:Postnatal Care / Q000379:methods* / Q000523:psychology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D037841:Pregnant People / Q000523:psychology; D036301:Qualitative Research; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Emotions; Multigravida; PTSD; Support needs; Survey; Traumatic birth