OBJECTIVE: To provide expert consensus recommendations for practice, policy, and research and theory.
METHODS: Two consultations (n = 65 and n = 43) with an international group of expert researchers and clinicians from 33 countries involved in COST Action CA18211; three meetings with CA18211 group leaders and stakeholders; followed by review and feedback from people with lived experience and CA18211 members (n = 238).
RESULTS: Recommendations for practice include that care for women and birth partners must be given in ways that minimise negative birth experiences. This includes respecting women\'s rights before, during, and after childbirth; and preventing maltreatment and obstetric violence. Principles of trauma-informed care need to be integrated across maternity settings. Recommendations for policy include that national and international guidelines are needed to increase awareness of perinatal mental health problems, including traumatic birth and childbirth-related PTSD, and outline evidence-based, practical strategies for detection, prevention, and treatment. Recommendations for research and theory include that birth needs to be understood through a neuro-biopsychosocial framework. Longitudinal studies with representative and global samples are warranted; and research on prevention, intervention and cost to society is essential.
CONCLUSIONS: Implementation of these recommendations could potentially reduce traumatic births and childbirth-related PTSD worldwide and improve outcomes for women and families. Recommendations should ideally be incorporated into a comprehensive, holistic approach to mental health support for all involved in the childbirth process.
目的:为实践提供专家共识建议,政策,研究和理论。
方法:与参与COSTActionCA18211的33个国家的专家研究人员和临床医生组成的国际小组进行了两次咨询(n=65和n=43);与CA18211小组负责人和利益相关者举行了三次会议;然后是有生活经验的人和CA18211成员的审查和反馈(n=238)。
结果:实践建议包括,对妇女和分娩伙伴的护理必须以尽量减少负面分娩经历的方式给予。这包括以前尊重妇女的权利,during,和分娩后;防止虐待和产科暴力。创伤知情护理的原则需要在产妇环境中整合。政策建议包括需要国家和国际准则来提高对围产期心理健康问题的认识,包括创伤性出生和分娩相关的创伤后应激障碍,并概述以证据为基础的,实用的检测策略,预防,和治疗。研究和理论建议包括需要通过神经生物心理社会框架来理解出生。有代表性和全球样本的纵向研究是必要的;以及预防研究,干预和社会成本至关重要。
结论:实施这些建议可能会在全球范围内减少创伤性分娩和分娩相关的PTSD,并改善妇女和家庭的结局。建议最好应纳入一个全面的,为所有参与分娩过程的人提供心理健康支持的整体方法。