INTERSECTplus

In Brazil, a study on Perinatal loss: Bereavement process after the experience of a traumatic birth has been carried out by Bárbara Albasini Bard (Master’s Student), supervised by Professor Daniela Centenaro Levandowski at UFCSPA (Federal University of Health Sciences of Porto Alegre), aiming at to compare the bereveament process of women who had a perinatal loss (the loss of the baby occurred between the 22nd week of pregnancy and seven days after birth) and perceived the birth process as traumatic or not. We applied the INTERSECT protocol from 6 to 12 weeks after the birth. Also, a semi-structured online interview was carried out to collect data on the experiences of these women. A preliminary statistical analysis showed significant differences between groups regarding PSTD (p=0,003), depression (p is less than 0,001) and anxiety (p=0,019) scores, as well as the perception of the birth as distressing (p=0,031); all the results were higher among the women who perceived the birth process as traumatic. In the preliminary qualitative analysis of the interviews, it can be seen that women who considered they have suffered obstetric violence, neglect or who do not know the cause of the baby's death, have greater difficulty in resigning the loss and finding a lasting connection with the deceased child. For more information please contact: danielal@ufcspa.edu.br

In the UK, Dr Georgie Constantinou and Dr Rebecca Webb are currently exploring the structure of maternity care in relation to birth-trauma and PTSD. Events during birth increase the risk of developing birth-trauma and PTSD e.g., negative birth experience, unplanned operative birth, and lack of support during birth. These events may be more likely to happen in certain maternity care settings. The funding (public vs private) and structure (hospital vs birth centre; midwifery led vs obstetric led) of maternity services varies between countries. Furthermore, some countries do not allow the birth partner to attend the birth. These differences in how maternity services are structured and offered will impact on maternal safety and outcomes and women’s experiences of pregnancy and birth. No previous research has attempted to understand how the way maternity systems are structured can impact on birth-related PTSD. It is important that this is researched because these findings have the potential to inform policy about childbirth practices. Objectives: 1. To identify different categorisation methods of maternity care systems using a systematic review (Phase 1) 2. To develop a measure of differences in maternity care systems using the results from Phase 1 (Phase 2) 3. To validate the measure of differences in maternity care through a panel of expert stakeholders (Phase 3) For more information please contact: georgina.constantinou@city.ac.uk

In Ireland, Ursula Nagle is currently undertaking a PhD at Trinity College Dublin titled ‘The Impact of Perinatal Trauma – A mixed methods study investigating and exploring the prevalence, women’s experiences and related factors associated with birth trauma in an Irish maternity setting’. Under the supervision of Prof Joan Lalor (Trinity College Dublin), Prof Susan Ayers (City University London) and Prof Antje Horsch (University of Lausanne), the study proposes to measure the prevalence, manifestations and etiology of childbirth-related PTSD (CB-PTSD) through INTERSECT study in one hospital-based location in Ireland, and to explore and understand the experiences of postnatal women with a history of interpersonal trauma (IPT) who also experience birth as a traumatic event. Within the interviews, there is a focus on help-seeking behaviours. This will be achieved using a two-phase mixed-methods study design. In phase 1 (quantitative), systematic sampling will identify participants who have experienced a traumatic birth from INTERSECT study. Results of this phase will provide new data on the prevalence, symptom presentation and etiology of birth-related trauma in Ireland. In phase 2 (qualitative), criterion-based sampling from INTERSECT will identify participants with a history of IPT who have experienced a traumatic birth. In-depth interviews will seek to explore and understand women’s experiences with a focus on help-seeking behaviour. Data collection for both phases is well underway and is expected to be completed in June 2024. Little is known about the impact of childbirth-related PTSD in Ireland. This is important knowledge which can impact national and international clinical practice, policy making and contribute to the development of trauma-informed evidence-based education, practice and service developments. ​ For more information please contact: nagleu@tcd.ie @PerinatalMW

The INTERSECT study also has three groups of researchers from different countries extending the study into specific areas of interest these include; ​ -Fathers/birth partners  -Fear of childbirth  -Mother-baby bond  These groups met frequently in the early stages of the study to decide upon the measures they would add to the core INTERSECT measures to collect additional data which could be analysed across countries on these interests. For more information please contact: intersect@city.ac.uk

Carried out by Ijlas El Founti-Khsim (PhD student) and supervised by Dr Rafael A. Caparros-Gonzalez, this project identifies risk factors for post-traumatic stress disorder after birth, undertakes a qualitative study on symptoms of PTSD after birth and determines prevalence of PTSD after birth in the South of Spain.  For more information please contact: rcg477@ugr.es

The INTERSECT study also has a postgraduate group which was set up by PhD Student Ursula Nagle from Ireland. This group was put in place to connect those postgraduate students working on the INTERSECT project internationally to give an opportunity to network and support one another. For more information or to join please contact: nagleu@tcd.ie