Screening for a Traumatic Birth Experience to Increase Identification of Maternal Mental Health Issues in the Postpartum Period

Abstract

Although birth is generally viewed as a positive experience, some patients perceive the experience to be traumatic. A traumatic birth experience (TBE) can result in perinatal mood and anxiety disorders, such as postpartum depression (PPD), childbirth related posttraumatic stress disorder (CB-PTSD), and suicidal ideations. The impact on the patient and family can be significant. This Doctor of Nursing Practice (DNP) project implemented screening for TBE during the newborn’s one-week phenylketonuria (PKU) appointment at a rural hospital. The purpose of this DNP project was to investigate the effectiveness of screening for TBE in the postpartum period to identify patients who were at a higher risk for developing maternal mental health issues. The middle range theory of traumatic childbirth guided the development and implementation of the project, focusing on the effects of traumatic birth on the patient, their partner, and the infant. The Johns Hopkins Evidence-Based Practice for Nursing and Healthcare Professionals Model directed the project. Data was collected in a pre-implementation phase (n=43) and a post-implementation phase (n=37), and referrals for follow-up care following PPD and TBE screening were analyzed to evaluate project outcomes. A Fisher’s Exact test compared TBE and referrals for follow-up, as well as TBE and the independent variables. Although the analysis was not statistically significant, screening was effective in identifying 8.1% of the patients as having a TBE (n=3) who would have not received referrals if TBE screening was not completed. This project was clinically significant, and continuation of screening is supported by the project site.