Midwifery 102 (2021) 103127

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Midwifery
journal homepage: www.elsevier.com/locate/midw

Review Article

A scoping review of maternity care providers experience of primary trauma

within their childbirthing journey
Lisa Charmer a,∗, Elaine Jefford b, Julie Jomeen c
a
Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia
b
Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia
c
Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia

a r t i c l e i n f o a b s t r a c t

Keywords: Objective: To examine and summarise available literature on maternity care practitioners having experienced
Trauma primary trauma during their childbirthing journey and whether this impacts their mental well-being and/or care
PTSD provision when subsequently caring for childbearing women.
Birth trauma
Background: Birth trauma affects 1 in 3 women; 1 in 20 women show post-traumatic stress disorder symptoms
Personal experience
by 12 weeks after birth. However, what is not known is what percentage of these women are maternity care
Maternity care practitioners
Midwife providers experiencing or having experienced personal trauma during their child birthing journey. This scoping
review aims to examine and summarise available literature on maternity care practitioners having experienced
primary trauma during their childbirthing journey and whether this impacts their mental well-being and/or care
provision when subsequently caring for childbearing women.
Methods: Arksey and O’Malley (2005) six-stage scoping review framework was revised and utilised. A search of
the relevant databases (MEDLINE Embase, CINAHL, APA PsycInfo, Scopus) was undertaken with several keywords
related to trauma and personal experience. Reference lists were also searched of studies identified for reading
the full text.
Findings: The search strategy identified 2983 articles. The studies excluded were considered to be unrelated to
the topic directly. A total of 352 articles were reviewed by abstract, and 29 additional studies were identified
from reference lists; 32 were reviewed by full text. A total of 0 studies met the inclusion criteria for the scoping
review.
Conclusions and implications for practice: The scoping review identified a gap in the literature as maternity care
practitioners personal experience of trauma during the child birthing journey has not been researched. Research
is needed to explore and conceptualise the experiences of maternity care practitioners having experienced trauma
and the ongoing implications this may have on their personal and professional lives.

Introduction
Several types of trauma are discussed in the literature; primary –
referring to the person experiencing a traumatic event, that is, their
own personal experience (American Psychiatric Association, 2013); sec-
ondary (secondary traumatic stress (STS)) (Beck, 2020; Beck, Cusson,
et al., 2017) – referring to the person being exposed to a traumatic
event through another person’s event, narrative or recount of the event.
(refer to Table 1.). STS is defined as “an occupational hazard for clin-
icians who can experience symptoms of posttraumatic stress disorder
from exposure to their traumatised patients.”, (Beck and Gable, 2012,
p. 747; Beck et al., 2015, p. 16). Similarly, compassion fatigue (CF) oc-
curs from the same experience, with the same onset and symptomology
(Stamm, 2010). Vicarious trauma is different to STS or CF in that it
occurs from the exposure to multiple traumatised patients repeatedly
and includes symptomology of cognitive disruption as well as intru-
sion, avoidance and arousal (refer to Table 2.) (Fenwick et al., 2018;
McCann and Pearlman, 1990; Sheen et al., 2014; Slade et al., 2017).
These definitions are particularly pertinent when looking at mater-
nity services as Maternity Care Providers (MCP’s) are predominantly fe-
male, and many may have walked their own birthing journey. [In other
words, experienced their own pregnancy, labour and birth, and early
parenting]. Further, as MCP’s work in a profession that frequently ex-
poses them to observing traumatic events (secondary trauma), it aligns

∗
Corresponding author at: Faculty of Health, Southern Cross University, Bilinga, QLD 4225, Australia.
E-mail address: Lisa.Charmer@scu.edu.au (L. Charmer).

https://doi.org/10.1016/j.midw.2021.103127
Received 4 March 2021; Received in revised form 21 June 2021; Accepted 3 August 2021
0266-6138/© 2021 Elsevier Ltd. All rights reserved.
L. Charmer, E. Jefford and J. Jomeen Midwifery 102 (2021) 103127

Table 1 The literature acknowledges some possible implications are: mother

Summary of trauma. and baby bonding, breastfeeding challenges, and relationship diffi-
Type of Trauma Definition culties and breakdown (Horsch and Garthus-Niegel, 2019; Kendall-
Tackett, 2015; Slade and Milby, 2017). Ultimately, decisions for
Primary Trauma (Beck, 2020; Beck, Cusson, Trauma that is personally and during future pregnancies may be challenging for these women
Gable, Dowling, and Thibeau, 2017) experienced (e.g. birth
(Ayers, 2014; Greenfield et al., 2016).
trauma experience)
Secondary Trauma (Beck, 2020; Beck, Cusson, Trauma from being The phenomenon of birth trauma, both for the woman (primary)
Gable, Dowling, and Thibeau, 2017) exposed to a traumatic [irrespective of if she is also an MCP], and the woman working as
event through another an MCP (secondary) [irrespective of whether having experienced a
person’s event, narrative
primary trauma], and the impact that this has on both, is widely
or recount of the event
Vicarious Trauma (Fenwick, Lubomski, Creedy, Trauma from the available (Adewuya et al., 2006; Baas et al., 2018; Bethea et al.,
and Sidebotham, 2018; McCann and exposure to multiple 2020; Calvert and Benn, 2015; Creedy and Gamble, 2016; Fontein-
Pearlman, 1990; Slade, Sheen, and Spiby, 2017) traumatised patients Kuipers et al., 2018; Hamama et al., 2019; Huggard and Dixon, 2011;
repeatedly Leinweber et al., 2017a, 2017b; Minooee et al., 2020; Rice and War-
land, 2013; Toohill et al., 2019; Yates et al., 2017). MCP’s experience
Table 2 trauma symptoms from birth trauma in the workplace (secondary),
A framework for considering the differences between hypothesised traumatic such as posttraumatic distress syndrome or posttraumatic stress disorder
stress responses. (PTSD) as it is better known (American Psychiatric Association, 2013;
Traumatic stress Level of exposure Onset Symptomology
Beck et al., 2015; Noonan et al., 2017; Sheen et al., 2015). PTSD is a
response psychiatric disorder that may occur in people who have experienced
or witnessed a traumatic event (e.g. a natural disaster, a serious ac-
Posttraumatic Stress Experience, witness Can occur Intrusion,
Disorder or hear about a immediately avoidance,
cident, a terrorist act, war/combat, or rape or who have been threat-
(American Psychiatric traumatic event after one event arousal ened with death, sexual violence or serious injury) (American Psy-
Association, 2000) chiatric Association, 2013; American Psychiatric Association, 2000).
Secondary Traumatic Hear about an event Can occur Intrusion, Sheen et al. (2014) provide an understanding of the traumatic stress
Stress (Figley, 1995) from a traumatised immediately avoidance,
response that MCP’s could experience, including loss and grief, de-
individual after one event arousal
Compassion Fatigue Hear about an event Can occur Intrusion, pression, compassion fatigue, vicarious traumatisation, and high lev-
(Stamm, 2010) from a traumatised immediately avoidance, els of birth fear (refer to Table 2). (Beck, 2011; Beck and Gable, 2012;
individual after one event arousal Calvert and Benn, 2015; Catherall, 1989; Figley, 1995; Sheen et al.,
Vicarious Hear about multiple Repeated Cognitive
2014; Toohill et al., 2019; Wahlberg et al., 2019).
Traumatisation events from many exposure to disruption.
(McCann and different individuals multiple events Intrusion,
Minooee et al. (2020), focusing only on midwives, provide additional
Pearlman, 1990) avoidance, categorisation of the degree of the impact of birth trauma (secondary)
arousal into the following three themes; psychological issues, professional con-
(Sheen et al., 2014) cerns, changes in practice and positive impact. Further, one or all of
these categories can influence midwives’ professional practice and clin-
ical decision making, and other areas of professional practice and im-
with being considered an occupational hazard (Beck, 2011; Jonsson and pacting personally (Minooee et al., 2020; Sheen et al., 2014). Yet there
Segesten, 2003). is a gap in Minooee et al. (2020) research on whether an MCP, who
This scoping review was conducted to explore any evidence within has experienced primary trauma in their own child birthing journey,
the literature that MCP’s who have experienced primary trauma in their has a differential impact upon their mental well-being or care provision
own childbirthing journey, the impact upon their mental well-being or when caring for childbearing women. This gap then raises the question
their care provision when subsequently caring for childbearing women. of whether there is evidence within the literature if MCP’s experiencing
primary trauma during their child birthing journey and subsequent ex-
posure when caring for childbearing women. If yes, does it affect their
Trauma in the maternity setting mental well-being and future care provision? Thus, exploration of the
literature was undertaken.
Traumatic events and the effects on humans is evident as far back
as 1900 B.C. (Morrissette, 2004). A traumatic event does not have to be
due to a major disaster, loss, unpleasant, or life-threatening event; it can
Methods
be anything that causes a person to feel threatened or at risk and create
a stress reaction (Creedy and Gamble, 2016; Gamble and Creedy, 2009).
Arksey and O’Malley (2005) provide a six-stage framework for
When applied to childbirth, traumatic birth is a term often used to de-
conducting a scoping review used to provide a systematic approach
scribe experiences during the birth process that cause distress lasting
to the literature search and a comprehensive foundation to guide it
longer than, and after, the immediate experience (Ayers et al., 2015;
(Arksey and O’Malley, 2005). The sixth stage of consulting with practi-
Greenfield et al., 2016). Yet, there is no one interpretation of traumatic
tioners and consumers, is optional and was not utilised.
birth, irrespective of whether the woman is also an MCP or not, as it
is subjective and personalised to each individual woman and can vary
in perceived severity (Greenfield et al., 2016; Leinweber et al., 2017a;
Minooee et al., 2020; Yates et al., 2017). Rather, the literature demon- Stage one: identify the research
strates the interchangeable use of terms (traumatic birth, birth trauma,
difficult birth, negative birth). A recent concept analysis attempts to of- According to Arksey and O’Malley (2005), stage one involves devel-
fer a consensus of traumatic birth as, oping a question for the scoping review. To address this, the mnemonic
“the emergence of baby from its mother in a way that involves events PPC (population, concept and context) was used; the population is
or care that cause deep distress or psychological disturbance, which may MCP’s; the concept is a personal experience of primary trauma during
or may not involve physical injury, but resulting in psychological dis- their own childbirthing journey, and the context of concurrently or sub-
tress of an enduring nature” (Greenfield et al., 2016, p. 257). sequently caring for childbearing women as an MCP.

2
L. Charmer, E. Jefford and J. Jomeen Midwifery 102 (2021) 103127

Table 3 This review can be considered an ‘empty review’ as no studies

were identified (Lang et al., 2007; San Lazaro Campillo et al., 2017;
Population Concept Context
Slyer, 2016; Yaffe et al., 2012). Whilst an empty review is considered
Midwife Primary trauma Life experience uncommon it does highlight a gap in the literature and the need for re-
Nurse midwife Traumatic birth Life or lived experience
search in a specific area. In this search strategy, every step was taken to
Maternal-child nurse Birth trauma
Doctor Complicated delivery ensure a broad inclusion of the literature. All types of literature; no date
Registrar Negative birth experience range limitation; the use of a framework to guide; review of abstracts
Medical staff Psychological trauma and full text of articles; a broad initial question was asked of the liter-
Obstetrician Trauma
ature search. These steps ensured this the empty review was not due
Emotional trauma
Posttraumatic stress
to limitations with the review strategy (Lang et al., 2007; San Lazaro
Campillo et al., 2017; Yaffe et al., 2012).

Stage four: charting the data

No data to chart due to no available literature.

Stage 5: collating, summarising and reporting

Due to this being an empty review, the final stage of Arksey and
O’Malley (2005) framework collating, summarising and reporting on
specific articles to support further research being required in the area
of MCP’s experience of primary trauma did not occur.

Findings

Overall summary of studies that support further research being required

No studies are available to provide an overall summary of MCP’s per-
sonal experience of primary trauma during their own childbirth journey.
Despite this being an empty review, we feel it is important to provide
the reader with a summary of the 20 studies out of the 32 articles identi-
fied within the penultimate stage of this scoping review and the quality
of that literature.
Fig. 1. PRISMA chart (Moher et al., 2009).
Data evaluation

The research questions are

A Mixed-Method Appraisal Tool (MMAT) was used to assess the qual-
ity of each of the 20 studies (Hong et al., 2018).
1. Is there evidence of MCP’s experiencing primary trauma during their
child birthing journey and subsequent exposure when caring for
Results
childbearing women?
2. How does this impact their mental well-being and future care provi-
The 20 studies had a range of participants who had experienced a
sion?
traumatic/significant event at work;

• midwives (11) with inclusion in four qualitative, six quantitative and

Stage 2: identify relevant studies
The second stage of the framework is to identify relevant studies
(Arksey and O’Malley, 2005). The inclusion criteria of English language;
MCP’s; primary trauma; no date restrictions or publication type was
applied to the following databases: MEDLINE Embase, CINAHL, APA
PsycInfo, Scopus, (see Appendix 1). This was to allow the initial inclu-
sion of literature that may relate in some way to MCP and personal
experience of trauma.
Stage 3: study selection
The study selection framework initially identified 4657 articles, from
which 1674 duplications were removed. The 2983 remaining studies
were saved to a specifically created Endnote database and reviewed by
title. Articles were included if the title incorporated MCP’s and any of
the keywords (refer to Table 3), any study that did not have any of these
keywords within the title was excluded. This left a total of 352 articles,
which were reviewed by abstract (320 excluded); 32 were further re-
viewed by full text, yet on closer analysis, it became apparent a total of
0 studies met the inclusion criteria for the scoping review (see Fig. 1 for
the PRISMA chart).
three mixed-method studies;
• nurses (seven) one qualitative, three quantitative and three mixed-
method;
• obstetricians, gynaecologists, medical staff and physicians (six) four
quantitative and two mixed-method.
When analysing the 20 papers about bias, four studies, two qualita-
tive (Fenwick et al., 2018; Leinweber et al., 2017a) and two quantita-
tive (Hamama et al., 2019; Huggard and Dixon, 2011), ranked slightly
lower due to having a risk of nonresponse bias, not being clearly ad-
dressed in the study design and method. However, the two studies with
the highest response rate (Toohill et al., 2019; Walker et al., 2020)
have the potential for response bias. Toohill et al. (2019) acknowledge
that the participants completed the survey voluntarily and may have a
specific interest in the topic leading to response bias, yet provides de-
tailed data from both data collection methods that provide great insight.
Walker et al. (2020) recruited participants from two hospital sites, one
of which had a low response rate and the second site recruited via pro-
fessional contacts, allowing for response bias. On closer examination,
32 participants completed a survey, but only eight go on to complete
interviews. This may account for the lack of synthesis of qualitative and
quantitative data and a dominant quantitative approach to this pilot

3
L. Charmer, E. Jefford and J. Jomeen
study’s findings. The qualitative studies identified generalised limita-
tions; small number of participants leading d to low response rate or se-
lective sampling limiting generalisability (Sheen et al., 2016a); length of
time from traumatic event to participants providing data varied amongst
all studies which may lead to difference/modified emotions. In the six
mixed-method studies, there was a wide range in participant response
rate 3% - 84%, and it is noted in the four lowest response rate studies to
limit the external validity of generalizability (Beck, Cusson, et al., 2017;
Beck et al., 2015; Beck, Rivera, et al., 2017; Slade et al., 2020). Notably
for consideration in planning any further research studies was the lim-
itation of participant involvement in the studies and the correlation to
one of the key symptoms of PTSD, that of avoidance (Slade et al., 2018).
Toohill et al. (2019) provides detailed information on the demo-
graphic data collected, male and female midwives, from all types of
clinical settings, with a good range of employment, age and qualifica-
tion level, in all kinds of settings (rural, remote and regional/metro),
and is the only study to make mention of midwives experiencing birth
trauma in their own labour and birth (n=41.6%).
Three studies (Beck, 2020; Beck, Cusson, et al., 2017; Beck et al.,
2015) were linked to secondary data from a primary study. Interest-
ingly, the primary author is the same for all three studies, which is ac-
knowledged and explained to ensure non-bias. However, the author also
points out the benefits of using secondary data, such as no recruitment
required, allows for different methods to be used, and confirms or dis-
counts the primary research (Beck, 2020; Beck, Cusson, et al., 2017;
Beck et al., 2015).
Findings
Demographics
Where provided within the 20 studies participants gender, age range,
and qualifications were collated [Walker et al. (2020) was the only study
that did not provide all]. Studies with midwifery participants that pro-
vided gender showed >97.6% were female (mean = 98.99%) (Beck, Cus-
son, et al., 2017; Beck et al., 2015; Nightingale et al., 2018; Sheen et al.,
2015; Sheen et al., 2016a, 2016b; Toohill et al., 2019). The studies
with medical staff, female gender varied considerably 48% - 71.1%
(mean = 60.7%) (Baas et al., 2018; Bethea et al., 2020; Hamama et al.,
2019; Huggard and Dixon, 2011; Slade et al., 2020).
The mean age of participants in the studies where provided was
43.87 years (Beck, 2020; Beck, Cusson, et al., 2017; Beck et al., 2015;
Bethea et al., 2020; Çankaya and Dikmen, 2020; Fenwick et al., 2018;
Hamama et al., 2019; Huggard and Dixon, 2011; Leinweber et al.,
2017a; Nightingale et al., 2018; Sheen et al., 2016a; Slade et al., 2018;
Toohill et al., 2019). The two studies with the significantly younger
mean age of midwifery participants Çankaya and Dikmen (2020) and
Huggard and Dixon (2011), offer no insight or explanation of why this
may be the case. Consideration needs to be given that Çankaya and Dik-
men (2020) was conducted in Turkey and acknowledges that the partic-
ipants (maternity/nurse midwife) worked in other areas than maternity
(surgery clinics, dialysis etc.), and how this could potentially attract a
younger workforce to these areas. However, recruitment ensured that
participants had witnessed or intervened in a significant event in the
maternity setting. Huggard and Dixon (2011) is a New Zealand based
study where midwifery models of care are midwifery lead and woman-
focused, with the potential to attract newly qualified midwives want-
ing to work in a midwifery lead model. Of the two, Çankaya and Dik-
men (2020) records the highest percentage of participants experiencing
PTSD (n=37.2%).
PTSD
Participants experiencing PTSD is stated in 8 of the 20 studies and
varies from 11.8% to as high as 36% (mean 24.6%) (Baas et al., 2018;
Beck et al., 2015; Çankaya and Dikmen, 2020; Nightingale et al., 2018;
4
Midwifery 102 (2021) 103127
Sheen et al., 2015; Slade et al., 2020; Slade et al., 2018; Walker et al.,
2020). The most common tools for the collection of quantitative data on
PTSD were the Diagnostic and Statistical Manual of Mental Disorders-
IV (DSM – IV/ DSM – IV-TR) (American Psychiatric Association, 2000),
Empathetic Concern measure (EC) (Davis, 1983), Maslach Burnout In-
ventory (MBI) (Horowitz et al., 1979) and Copenhagen Burnout Inven-
tory (CBI) (Kristensen et al., 2005), Impact of Event Scale-Revised (IES-
R) (Weiss and Marmar, 1997), and Attitudes to Professional Role Scale
(APRS) (Turnbull et al., 1995). In addition, three studies used four of the
tools in the study to collect qualitative and quantitative data adding to
the clear identification of PTSD in MCP’s (Sheen et al., 2015; Slade et al.,
2020; Slade et al., 2018), and providing in-depth knowledge of the par-
ticipant’s experience of the same.
Geographical location of study
There was evidence of geographical clustering with the studies, with
the majority based in the USA and Canada, UK and Ireland, and Australia
and New Zealand, all with an equal number of studies (n=6). There were
single studies from Turkey, Israel and Netherlands. It is hypothesised
that only a small number of researchers and clinicians in this area are
within these high-income countries. Interestingly the studies with the
more significant participant numbers were two studies from Australia
(n=990 (Fenwick et al., 2018) and n=687 (Leinweber et al., 2017a))
and the UK (n=1905) (Slade et al., 2020). These more significant par-
ticipant numbers may reflect some of the country’s similarities, popula-
tion and healthcare systems/settings in the studies (Fenwick et al., 2018;
Leinweber et al., 2017a; Slade et al., 2020). In most studies, recruitment
did not rely on one institution/facility, thus providing far-reaching par-
ticipation and data collection.
MCP’s personal experience of primary trauma from an event/s dur-
ing their own child birthing journey is not evident within the 20 stud-
ies. However, the rates of secondary trauma experienced by MCP’s is
apparent in a plethora of literature. This highlights the need for further
research into primary trauma experienced by MCP’s.
MCPs and primary trauma
Primary trauma personally experienced by MCP’s during their child
birthing journey is not discussed in the literature. It is feasible to assume
that there would be a significant number of those MCP’s as participants
in those broader studies, but this is not evident to date. This would sug-
gest that a substantial number of MCP’s suffer primary trauma leading
to PTSD from their birth trauma, unknown, and then return to the clin-
ical setting. Secondary trauma is discussed in literature in detail and in
relation to MCP’s.
MCPs and secondary trauma
As noted previously, secondary trauma experienced by MCP’s is
an international phenomenon with studies in Australia and New
Zealand, the United States of America (USA) and the United King-
dom (UK), Canada, Israel, Turkey, and Poland. Twelve studies on MCP
secondary trauma identified a significant number of female MCP’s
(>50%) (Baas et al., 2018; Beck, 2020; Beck, Rivera, et al., 2017;
Bethea et al., 2020; Hamama et al., 2019; Huggard and Dixon, 2011;
Nightingale et al., 2018; Sheen et al., 2015; Sheen et al., 2016a, 2016b;
Toohill et al., 2019; Walker et al., 2020).
The number of MCP’s experiencing secondary trauma and clinical
PTSD symptomology from the same is highlighted in Beck (2020) study
of secondary traumatic stress in labour within the USA. Confirmed PTSD
symptoms from secondary trauma experiences were found in delivery
nurses, midwives, and neonatal intensive care unit (NICU) nurses whilst
caring for women during traumatic births or caring for critically ill in-
fants. Whilst Sheen et al. (2015), who looked at UK midwives, found
that 33% of participants were experiencing clinical symptoms of PTSD
L. Charmer, E. Jefford and J. Jomeen Midwifery 102 (2021) 103127

related to experiencing perinatal traumatic events during care provision Declaration of Competing Interest
for women. Baas et al. (2018) identified a scarcity of data about obste-
tricians and gynaecologists experiencing PTSD from birth trauma, even The authors declare that they have no known competing financial
though it found increasing numbers from the study, which supports the interests or personal relationships that could have appeared to influence
need for further research, in agreement with Walker et al. (2020). In- the work reported in this paper.
terestingly, in the recent pilot study by Walker et al. (2020) focusing on
Australian obstetricians, 96.9% had experienced trauma and symptoms Ethical approval
(n=34) within their clinical setting and role as an MCP, with 34 having
current symptoms at the time of data collection. Walker et al. (2020) sig- Not applicable.
nificant finding of 96.9% supports the need for further research.
A limitation across all of the 20 studies is the lack of detail or ex- Funding sources
ploration about MCP’s personal experience of primary trauma from an
event/s during their own child birthing journey. This limitation is fur- Not applicable.
ther compounded by the researcher’s failure to explore whether this
primary trauma is relevant to the secondary trauma event and clinical Appendix
PTSD symptomology. This, therefore, poses two key questions:
Appendix 1
• Are MCP’s experiencing PTSD symptomology from a personal pri-
mary trauma event from their child birthing journey? SEARCH EBSCO (CINAHL, COCHRANE SCOPUS
• Are MCP’s exposed to subsequent trauma events on returning to the MEDLINE and APA
PSYCHINFO)
clinical setting?
1 (MH "Maternal-Child 16,184 191900
The exact implications are not known to the MCP’s health and well- Nursing") OR (MH (S1, S2
being and their professional and clinical care provision. "Midwives") and S3)
2 MH "Nurse Midwives") 9551
MCPs and primary trauma OR (MM "Nurse
Midwives")
3 Midwi∗ 140,012
Primary trauma personally experienced by MCP’s during their child
4 Doctor∗ or "medical 428,620 1144922
birthing journey is not discussed in the literature. It is feasible to assume staff" or registrar∗ or
that there would be a significant number of those MCP’s as participants obstetrician∗
in those broader studies, but this is not evident to date. This would sug- 5 “primary trauma” 326 15613
gest that a substantial number of MCP’s suffer primary trauma leading to (S5, S6,
S7)
PTSD from their birth trauma, unknown, and then return to the clinical
6 (MH "Psychological 2716
setting. Trauma+")
7 “Traumatic birth∗ ” or 2867
Discussion “birth trauma “or
“complicated deliver∗ ”
or “negative birth
MCP’s known trauma from secondary exposure leading to PTSD is
experience∗ ”
well researched and highlights an increasing number of MCP’s suffering 8 S1 OR S2 OR S3 OR S4 563,590 1304255
from emotional distress, PTSD symptomology, and the significant ongo- 9 (S5 OR S6 OR S7) AND 438 2686
ing impact this has on their personal and professional life (Baas et al., S8
2018; Beck et al., 2015; Nightingale et al., 2018; Sheen et al., 2015; 10 S5 AND S6 AND S8 0
11 (S5 AND S6 AND S8) OR 243 7350
Walker et al., 2020). Yet, we have identified three clear gaps in the lit-
(S7 AND S8)
erature: 12 DE “Trauma “OR DE 103,855
“Birth Trauma “OR DE
1. Current trauma literature does not distinguish MCP’s;
“Emotional Trauma “OR
2. MCP’s and secondary trauma has been the focus of previous research DE “Injuries “OR DE
3. The impact on MCP’s who experience primary trauma from their “Moral Injury “OR DE
child birthing journey and return to the clinical setting providing “Posttraumatic Growth”
care for women has not been explored or DE Posttraumatic
stress “OR DE
Further research into their child birthing journey and what subse- “Traumatic Brain Injury
quent trauma or psychological distress do MCP’s bring to the workplace “OR DE “Traumatic
Loss”
with them from that experience is needed. MCP’s having experienced
13 S8 AND S12 1543
their own trauma will have an altered response and symptoms of PTSD 14 DE “Life experiences 414915 104308
to secondary trauma in the workforce, which may lead to MCP’s leaving “OR (MH “Life
the workforce to negate such response, symptoms and experiences. Al- experiences”) OR (life
ternatively, it could see MCP’s remaining in the workforce experiencing OR lived) AND
experience∗
lifelong ongoing significant issues. S13 AND S14 183
15 2 reviews
Conclusion/Implications for practice

What is clear from the literature is that an increasing number of References

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