Advertisement

Catastrophic thinking: Is it the legacy of traumatic births? Midwives’ experiences of shoulder dystocia complicated births

Published:September 03, 2020DOI:https://doi.org/10.1016/j.wombi.2020.08.008

      Abstract

      Background

      Shoulder dystocia (SD) is considered one of the most traumatic birth experiences not only for women, but for clinicians involved as well. Adverse effects of birth trauma on the emotions and psyche of midwives have been well established.

      Aim

      To explore the impact of SD, as a birth trauma, on midwives’ orientation towards normal births and on their clinical practice and the factors which may deteriorate or improve the experience of SD.

      Methods

      In a qualitative descriptive study design, 25 in-depth interviews were undertaken with Australian midwives who had experienced at least one case of SD. Data were analysed thematically.

      Findings

      A total of four themes emerged: 1) an unforgettable birth; a wake-up call, 2) from passion to caution, 3) factors worsening the experience, and 4) factors soothing the experience. Fear, anxiety and doubt about their professional competence were the most common feelings experienced by midwives after SD. For many, the first exposure to SD left them contemplating their previous attitude towards normal birth. Disturbed orientation of normal birth shifted midwives towards hypervigilance in practice. Not having effective relationships with women and receiving poor support from colleagues were perceived to worsen the traumatic experience, whereas working in a midwifery continuity of care model and the sense of being appreciated improved midwives’ experience after the trauma.

      Conclusion

      Shoulder dystocia is a birth emergency that midwives will inevitably experience. Involvement in such births can potentially direct midwives towards a ‘worst case scenario’ mentality and affect the way they provide care for women in future.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Women and Birth
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Leinweber J.
        • Creedy D.K.
        • Rowe H.
        • Gamble J.
        Responses to birth trauma and prevalence of posttraumatic stress among Australian midwives.
        Women Birth. 2017; 30: 40-45
        • Cohen R.
        • Leykin D.
        • Golan-Hadari D.
        • Lahad M.
        Exposure to traumatic events at work, posttraumatic symptoms and professional quality of life among midwives.
        Midwifery. 2017; 50: 1-8
        • Beck C.T.
        • Gable R.K.
        A mixed methods study of secondary traumatic stress in labor and delivery nurses.
        J. Obstet. Gynecol. Neonatal Nurs. 2012; 41: 747-760
        • Beck C.T.
        • LoGiudice J.
        • Gable R.K.
        A mixed-methods study of secondary traumatic stress in certified nurse-midwives: shaken belief in the birth process.
        J. Midwifery Womens Health. 2015; 60: 16
        • Rice H.
        • Warland J.
        Bearing witness: midwives experiences of witnessing traumatic birth.
        Midwifery. 2013; 29: 1056-1063
        • Sheen K.
        • Spiby H.
        • Slade P.
        The experience and impact of traumatic perinatal event experiences in midwives: a qualitative investigation.
        Int. J. Nurs. Stud. 2016; 53: 61-72
        • Wahlberg Å
        • Högberg U.
        • Emmelin M.
        The erratic pathway to regaining a professional self-image after an obstetric work-related trauma: a grounded theory study.
        Int. J. Nurs. Stud. 2019; 89: 53-61
        • McDaniel L.
        • Morris C.
        • Ws Health
        The second victim phenomenon: how are midwives affected?.
        J. Midwifery Womens Health. 2020;
        • Leinweber J.
        • Creedy D.K.
        • Rowe H.
        • Gamble J.
        A socioecological model of posttraumatic stress among Australian midwives.
        Midwifery. 2017; 45: 7-13
        • Wu A.W.
        Medical error: the second victim. The doctor who makes the mistake needs help too.
        BMJ. 2000; 320: 726-727
        • Beck A.T.
        Thinking and depression. I. Idiosyncratic content and cognitive distortions.
        Arch. Gen. Psychiatry. 1963; 9: 324-333
        • Beck A.T.
        Cognitive Approaches to Anxiety Disorders.
        Springer, Boston, MA1986
        • Beck A.T.
        • Rush A.J.
        • Shaw B.F.
        • Emery G.
        Cognitive Therapy of Depression.
        Guilford Press, New York1979
        • Beck A.T.
        Cognitive Therapy and the Emotional Disorders.
        Penguin, 1979 (ISBN: 9781101659885)
        • Healy S.
        • Humphreys E.
        • Kennedy C.
        A qualitative exploration of how midwives’ and obstetricians’ perception of risk affects care practices for low-risk women and normal birth.
        Women Birth. 2017; 30: 367-375
        • Lavoie S.
        • Talbot L.R.
        • Mathieu L.
        Post-traumatic stress disorder symptoms among emergency nurses: their perspective and a’ tailor-made’ solution.
        J. Adv. Nurs. 2011; 67: 1514-1522
        • American Psychiatric Association
        Diagnostic and Statistical Manual of Mental Disorders.
        5th edition. 2013 (Washington)
        • Schwappach D.L.
        • Boluarte T.A.
        The emotional impact of medical error involvement on physicians: a call for leadership and organisational accountability.
        Swiss Med. 2009; 139: 9-15
        • Dahlen H.G.
        • Caplice S.
        What do midwives fear?.
        Women Birth. 2014; 27: 266-270
        • O’Leary J.A.
        Shoulder Dystocia and Birth Injury: Prevention and Treatment.
        Springer Science Business Media, 2009
        • Beck C.T.
        The obstetric nightmare of shoulder dystocia: a tale from two perspectives.
        MCN Am. J. Matern. Child Nurs. 2013; 38: 34-40
        • Creswell J.W.
        • Poth C.N.
        Qualitative Inquiry and Research Design: Choosing Among Five Approaches.
        Sage publications, 2016
        • Sandelowski M.
        Whatever happened to qualitative description?.
        Res. Nurs. Health. 2000; 23: 334-340
        • American College of Obstetricians and Gynecologists
        Practice bulletin no 178: shoulder dystocia.
        Obstet. Gynecol. 2017; 129: e123-e133
        • Bernard H.R.
        Research Methods in Anthropology: Qualitative and Quantitative Approaches.
        Rowman & Littlefield, 2017
        • Pope C.
        • Ziebland S.
        • Mays N.
        Analysing qualitative data.
        BMJ. 2000; 320: 114-116
        • Thomas J.
        • Harden A.
        Methods for the thematic synthesis of qualitative research in systematic reviews.
        BMC Med. Res. Methodol. 2008; 8: 45
        • Ellis A.
        Reason and Emotion in Psychotherapy.
        Lyle Stuart, New York1962
        • Miller M.M.
        • Meints S.M.
        • Hirsh A.T.
        Catastrophizing, pain, and functional outcomes for children with chronic pain: a meta-analytic review.
        Pain. 2018; 159: 2442-2460
        • Moore E.
        • Adams H.
        • Ellis T.
        • Thibault P.
        • Sullivan M.J.L.
        Assessing catastrophic thinking associated with debilitating mental health conditions.
        Disabil. Rehabil. 2018; 40: 317-322
        • Wahlberg A.
        • Andreen Sachs M.
        • Johannesson K.
        • Hallberg G.
        • Jonsson M.
        • Skoog Svanberg A.
        • et al.
        Post-traumatic stress symptoms in Swedish obstetricians and midwives after severe obstetric events: a cross-sectional retrospective survey.
        BJOG. 2017; 124: 1264-1271
        • Croskerry P.
        • Singhal G.
        • Mamede S.
        Cognitive debiasing 1: origins of bias and theory of debiasing.
        BMJ Qual. Saf. 2013; 22: ii58-ii64
        • Cuthreill K.B.
        The Snowball Effect: How to Build Positive Momentum in Your Life.
        AuthorHouse, 2014
        • Van Gerven E.
        • Bruyneel L.
        • Panella M.
        • Euwema M.
        • Sermeus W.
        • Vanhaecht K.
        Psychological impact and recovery after involvement in a patient safety incident: a repeated measures analysis.
        BMJ Open. 2016; 6e011403
        • Beck C.T.
        Middle range theory of traumatic childbirth: the ever-widening ripple effect.
        Glob. Qual. Nurs. Res. 2015; 22333393615575313
        • Elmir R.
        • Pangas J.
        • Dahlen H.
        • Schmied V.
        A meta-ethnographic synthesis of midwives’ and nurses’ experiences of adverse labour and birth events.
        J. Clin. Nurs. 2017; 26: 4184-4200
        • Burlison Jd
        • Quillivan Rr
        • Scott Sd
        • Johnson S.
        • Hoffman Jm.
        The effects of the second victim phenomenon on work-related outcomes: connecting self-reported caregiver distress to turnover intentions and absenteeism.
        J. Patient Saf. 2016; 10: 1097
        • Ullström S.
        • Andreen Sachs M.
        • Hansson J.
        • Ovretveit J.
        • Brommels M.
        Suffering in silence: a qualitative study of second victims of adverse events.
        BMJ Qual. Saf. 2014; 23: 325-331
        • Katsantoni K.
        • Zartaloudi A.
        • Papageorgiou D.
        • Drakopoulou M.
        • Misouridou E.
        Prevalence of compassion fatigue, burn-out and compassion satisfaction among maternity and gynecology care providers in Greece.
        Mater. Sociomed. 2019; 31: 172-176
        • Kahneman D.
        • Fredrickson B.L.
        • Schreiber C.A.
        • Redelmeier D.A.
        When more pain is preferred to less: adding a better end.
        Psychol. Sci. 1993; 4: 401-405