Trauma-sensitive obstetrics: Potential for optimization from the providers' perspectives

Traumatic birth experiences are increasingly recognized as a significant issue in maternity care. While many studies focus on the perspectives of birthing persons, little is known about how healthcare providers perceive the causes of traumatic births and possible strategies to prevent them. This study explores obstetric care providers' perceptions of factors contributing to traumatic birth experiences and their suggestions for improving trauma sensitive obstetric care.

A convergent parallel mixed methods design was used. An online survey among obstetric care providers in Germany was conducted between October 2024 and February 2025 (n=102). Quantitative data were analyzed descriptively and using logistic regression models. In addition, four expert interviews were conducted and analyzed using qualitative content analysis. Findings from both strands were integrated during interpretation.

Most respondents defined traumatic birth experiences primarily through loss of control (85.3%) and negative emotions (75.5%). Lack of communication and information was identified as the most important contributing factor (97.1%), followed by lack of emotional support (89.2%). Emotional support was rated as the most important preventive measure (mean=4.86; SD=0.51). The main barriers to trauma sensitive care were lack of time (mean=4.52; SD=0.81) and staff shortages (mean=4.35; SD=0.83). Interview findings highlighted structural challenges, the importance of reflective practice among caregivers, and the need for systematic training in trauma sensitive communication.

The findings highlight the need to strengthen trauma sensitive approaches in obstetric care through improved communication, emotional support, and shared decision making. In addition to structural improvements such as adequate staffing, regular training and reflective practice among providers may help reduce traumatic birth experiences.