A rapid evidence review of postnatal listening services for women following a traumatic or negative childbirth experience

Abstract

Problem: Currently there is a lack of clear guidance to underpin postnatal listening services for women who have had a traumatic or difficult birth.

Background: Postnatal listening (or birth reflections) services are important to help women review their birth and ask questions about their care, but currently there is no clear guidance on how these services should be provided.

Aim: To synthesise existing evidence on postnatal listening services for women following a traumatic or negative childbirth experience.

Methods: A rapid evidence review using four databases (PsycINFO, CINAHL, Medline, Web of Science), backward and forward chaining, and hand searches of previous systematic reviews. The Mixed Methods Appraisal tool was used to appraise the studies. Quantitative and qualitative data were synthesised into descriptive themes.

Findings: Database searches (n = 9,459 hits), backward and forward chaining and hand searching identified 27 articles for inclusion. Nineteen different services are described, evaluated as part of controlled trials (n = 16) or using quantitative and/or qualitative data (n = 8); three studies are audits of UK services. Findings are reported in 5 themes, 'Who provides the service?', 'Types and quality of care', 'Targeting the support', 'Timing and location', and 'Training and experiences of maternity staff'.

Discussion: The findings identify who, how, when, where and what should be provided within postnatal listening services. Services should be flexibly provided by trained maternity staff via active listening, empathy, and a non-judgmental approach.

Conclusion: Further work is needed to develop an optimum training programme, to identify key components of effectiveness, and to ensure these services are culturally relevant.

Keywords: Birth trauma; Childbirth; Counselling; Debriefing; PTSD; Postnatal.