Policy, service, and training provision for women following a traumatic birth: An international knowledge mapping exercise

Gill Thomson*, Magali Quillet Diop, Suzannah Stuijfzand, Antje Horsch, COST After birth Consortium including Maria Healy

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: High numbers of women experience a traumatic birth, which can lead to childbirth-related post-traumatic stress disorder (CB-PTSD) onset, and negative and pervasive impacts for women, infants, and families. Policies, suitable service provision, and training are needed to identify and treat psychological morbidity following a traumatic birth experience, but currently there is little insight into whether and what is provided in different contexts. The aim of this knowledge mapping exercise was to map policy, service and training provision for women following a traumatic birth experience in different European countries. Methods: A survey was distributed as part of the COST Action “Perinatal mental health and birth-related trauma: Maximizing best practice and optimal outcomes”. Questions were designed to capture ‘country level data’; ‘care provision’ (i.e., national policies or guidelines for the screening, treatment and/or prevention of a traumatic birth, service provision), and nationally mandated pre-registration and post-registration ‘training’ for maternity professionals. Results: Eighteen countries participated. Only one country (the Netherlands) had national policies regarding the screening, treatment, and prevention of a traumatic birth experience/CB-PTSD. Service provision was provided formally in six countries (33%), or informally in the majority (78%). In almost all countries (89%), women could be referred to specialist perinatal or mental health services. Services tended to be provided by midwives, although some multidisciplinary practice was apparent. Seven (39%) of the countries offered ‘a few hours’ professional/pre-registration training but none offered nationally mandated post-registration training. Conclusions: A traumatic birth experience is a key public health concern. Evidence highlights important gaps regarding formalized care provision and training for care providers.

Original languageEnglish
Number of pages29
JournalBMC Health Services Research
Publication statusAccepted - 21 Oct 2021

Bibliographical note

Co-Authors COST Afterbirth Consortium: Wilson de Abreu (; wjabreu@esenf.pt), Valérie Avignon (Woman-Mother-Child Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; valerie.avignon@chuv), Barbara Baranowska (bbaranowska@gmail.com), Pelin Dıkmen (pelindikmen@gmail.com), Wissam El Hage (wissam.elhage@univ-tours.fr), Yvonne Fontein-Kuipers (yvonne.fontein-kuipers@ap.be), Susan Garthus-Niegel (susanniegel@gmail.com), Gözde Gökçe (gozdegokce@gmail.com), Ernesto Gonzalez Mesa (egonzalezmesa@gmail.com), Eleni Hadjigeorgiou (eleni.hadjigeorgiou@cut.ac.cy), Maria Healy (maria.healy@qub.ac.uk), Figen Inci (figeninci@gmail.com), Ljiljana Jelicic (lilijen@ymail.com), Inga Karlsdóttir (inga@unak.is), Joan Lalor (LALORJ1@tcd.ie), Patricia Leahy (patricia.leahy@ucc.ie), Julia Leinweber (julia.leinweber77@gmail.com), Sylvia Murphy (Sylvia.Murphy@ul.ie), Ursula Nagle (umnagle@gmail.com), Jenny Patterson (jenny@jpmidwifery.co.uk), Jessica Pehlke-Milde (pehl@zhaw.ch), Mirjana Sovilj (iefpgmir@gmail.com), Claire Stramrood (claire.stramrood@gmail.com), Anastasia Topalidou (atopalidou@uclan.ac.uk), Marysia Wegrzynowska (marysia.wegrzynowska@gmail.com),


  • traumatic birth
  • services
  • policy
  • education
  • training
  • survey


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