(315) Trauma-Informed Maternity Care: Insights from Women’s Experiences after perinatal counseling

Objective:
To explore how women with histories of sexual trauma, obstetrical trauma or complex emotional backgrounds experienced peripartum, trauma-informed care by a midwife and to understand which aspects were perceived as supportive, what challenges remained to be improved or expanded.

Study Design:
A qualitative, multiple case study design, focusing on in-depth analysis of eight individual cases. Each case included a semi-structured interview with the woman after childbirth, along with examination of relevant clinical documentation and narrative accounts of trauma. The data were analyzed using reflexive thematic analysis, with attention to both shared patterns and individual variations across cases.

Results:
Four central themes emerged:

Relational Safety through Attuned Communication: Women described feeling emotionally safe when clinicians listened without judgment, respected boundaries, and offered genuine presence. This trust countered prior experiences of objectification and fostered a reparative relational dynamic.

Emotional and Somatic Preparation as Anchors for Control: The structured care model-including personalized birth plans and preparatory conversations, was seen as empowering. These tools enabled regaining a sense of choice and predictability.

Limits of Preparation and Re-encountering Trauma during Birth: Some women experienced moments of helplessness, fear, or trauma activation during labor, often arising when medical circumstances changed unexpectedly, highlighting the need for flexible, real-time emotional support.

Need for Integrated and Continuous Psychosocial Support: Participants expressed a desire for continuity of care. The emotional and psychological needs postpartum were often unmet, suggesting the necessity of more holistic and long-term trauma-informed maternity services.

Conclusion:
Trauma-informed approaches may enhance safety, agency, and emotional well-being during pregnancy and childbirth. However, postpartum care may be essential for truly comprehensive, trauma-sensitive maternity care.