The Journey of Perinatal Women’s Lived Experience of Traumatic Birth, Breastfeeding, Caregiving, and Bonding Using Photovoice and the Diary-Interview Method

Abstract

Traumatic birth, defined as when a mother suffers deep distress that lingers beyond her birth experience, may have enduring effects on the maternal-infant dyad. Breastfeeding provides a multitude of benefits which could offset the negative repercussions of traumatic birth. Yet, traumatic birth and breastfeeding intertwine with many factors, such as broader ecological systems (e.g., cultural norms) that may exert hidden forces on perinatal women’s lived experience. In particular, the bioEcoLogical pEriNatal womAn (ELENA) model, an adapted bioecological perspective, creates a framework to explore these interactions that may contribute to health disparities, especially for women of color. Therefore, the aims of this study were to (a) comprehend what led to traumatic birth and its impact on breastfeeding, caregiving, and bonding; (b) determine if and how breastfeeding may serve as a protective factor after traumatic birth; and (c) improve future care practices for perinatal women based on these findings. The goal was to empower women by giving them the opportunity to share their narratives. Interpretative phenomenological analysis methodology was used, utilizing the diary-interview method, photovoice, and research journal to gather and analyze participant narratives through oral, written, and visual means. Through purposive sampling, 13 participants with 15 traumatic birth stories were recruited from the Midwest and Southwest regions of the United States. Nine themes in total emerged with traumatic birth creating a ripple effect for certain themes under breastfeeding, caregiving, and bonding. The themes identified for traumatic birth were (a) Setting the stage, (b) A terrifying ordeal, and (c) Lost ideals of motherhood. For the ripple effect, the themes were (d) Enduring challenges, (e) Lost ideals of motherhood, (f) Going to the extreme to care for you; and (g) Support: It takes a village. Unique themes that emerged under a particular domain included for caregiving: (h) The parenting journey: From guilt to grace; and for bonding: (i) My motivation to persevere. Implications from this study indicate that more women may be affected by traumatic birth than previously considered, breastfeeding may act as a psychological protective factor for mothers, and current cultural norms and hospital policies may be impeding optimal maternal-infant functioning. Further research is needed to determine what contributes to traumatic birth, such as for women of color, how breastfeeding may be protective for mothers and infants, and what types of support would be beneficial for perinatal women and their families.