Figure 2 - uploaded by Penny Simkin
Content may be subject to copyright.
![The Pain Coping Scale: 10 to 0, developed to assess coping during labor and birth. Adapted from " Wong–Baker Faces Pain Rating Scale " in Clinical Handbook of Pediatric Nursing (2nd ed., p. 373), by D. Wong and L. Whaley, 1986, St. Louis, MO: C.V. Mosby Company, for " Pain Medications for Labor & Birth " [PowerPoint slides], by P. Simkin, 2010, Waco, TX: Childbirth Graphics.](profile/Penny-Simkin/publication/225086687/figure/fig2/AS:341772040458246@1458496212472/The-Pain-Coping-Scale-10-to-0-developed-to-assess-coping-during-labor-and-birth.png)
The Pain Coping Scale: 10 to 0, developed to assess coping during labor and birth. Adapted from " Wong–Baker Faces Pain Rating Scale " in Clinical Handbook of Pediatric Nursing (2nd ed., p. 373), by D. Wong and L. Whaley, 1986, St. Louis, MO: C.V. Mosby Company, for " Pain Medications for Labor & Birth " [PowerPoint slides], by P. Simkin, 2010, Waco, TX: Childbirth Graphics.
Source publication
In this column, Kimmelin Hull, community manager of Science & Sensibility, Lamaze International's research blog, reprints and discusses a recent blog post series by acclaimed writer, lecturer, doula, and normal birth advocate Penny Simkin. Examined here is the fruitful dialog that ensued-including testimonies from blog readers about their own exper...
Context in source publication
Context 1
... more important is the woman's ability to cope. Figure 2 illustrates the Pain Coping Scale, an adaptation of the Pain Intensity Scale that I developed to assess coping during labor and birth. If a woman rates her pain at 8 (very high) and her coping is also rated very high, she is not suffering. ...
Similar publications
Objetivo:
Investigar associação entre analgesia farmacológica e desfechos do parto.
Métodos:
Estudo transversal que utilizou amostra representativa dos partos realizados em 2013, em uma maternidade de Belo Horizonte, Minas Gerais. Foram incluídos dados de 978 partos, excluindo-se as cesarianas eletivas. A exposição principal foi o uso de analgesia...
Citations
... Furthermore, women with a history of trauma may be more likely to perceive childbirth as traumatic, thereby triggering or exacerbating PTSD symptoms Hopkins and Hellberg 2021). Indeed, regardless of past exposure to trauma, childbirth itself can be a traumatic event (Boorman et al. 2014;Simkin 2011), with up to 33% of women experiencing birth-related PTSD symptoms (Creedy et al. 2000). ...
There is heightened risk for maternal posttraumatic stress disorder (PTSD) during the perinatal period. However, it is unclear whether pregnancy and childbirth uniquely contribute to PTSD symptoms above and beyond elevations in negative affectivity that commonly occur among postpartum women (e.g., irritability, fatigue, depressed mood) and past trauma exposure. The present study explored the associations between childbirth stressors and trauma-related distress (TRD; intrusion and avoidance symptoms) across the 2 years following childbirth in a community sample of women (n = 159). Maternal TRD was assessed at pregnancy and four additional timepoints across 2 years postpartum. At pregnancy, mothers completed surveys measuring exposure to trauma and pregnancy-related anxiety. They also reported on pregnancy and childbirth complications across the first 6 months postpartum. Consistent with predictions, labor/delivery complications uniquely predicted increased maternal intrusions during the first 6 months postpartum above and beyond past trauma exposure. Furthermore, growth mixture models identified a subset of women with intrusion symptoms that persisted up to 2 years postpartum and, on average, exceeded the screening threshold for PTSD. Women who experienced greater labor complications were more likely to exhibit this clinical profile relative to low, stable symptoms. Findings highlight the importance of ongoing screening for TRD across the first 2 years postpartum, particularly among women who experience greater labor/delivery complications.
... Published studies report rates of PTSD after childbirth as varying between 1.5 and 9 percent of all births [5][6][7][8][9][10]. The differences among study findings are partly explained by differences in study designs, assessment tools, study populations [11], usual maternity care practices and caregiver attitudes [12,13]. ...
Traumatic childbirth is an international public health problem because it is supposed that currently up to 45% of new mothers have reported such an experience. International rates of PTSD due to birth trauma range between 1.5 and 9 percent of all births.
Birth trauma is defined as an event occurring during the labour and delivery process that involves actual or threatened serious injury or death of the mother or her infant.
A traumatic event or situation creates psychological trauma when it overwhelms the individual’s ability to cope, and leaves that person fearing death, annihilation, mutilation, or psychosis. The individual may feel emotionally, cognitively, and physically overwhelmed.
The aim of this article is to present a review of published data for childbirth trauma over various periods of time, as well as in different regions of the world. Studies were identified through a comprehensive search of PubMed, PsycInfo, ProQuest and PILOTS (Published International Literature of Traumatic Stress) over the last 20 years.
More than 8000 articles were found. In this article we present and discuss some important findings.
... Considering the increasing trend of preterm birth [2], its high resulting mortality and morbidity [29], and consequently the issues in maternal mental health and mother-child bonding [30], on one hand, lack of study in Iran, on the other hand, the present study aimed to evaluate the effect of supportive counseling on mental health in Iranian mothers of premature infants (primary outcome), mother-child bonding and infant anthropometric indices (secondary outcomes) in mothers of premature infants. ...
Abstract Background Premature birth can affect maternal mental health. Considering that the mental health disorder in mothers may play a vital role in the growth and development of their children, therefore, this study was conducted to determine the effect of supportive counseling on mental health (primary outcome), mother-child bonding and infant anthropometric indices (secondary outcomes) in mothers of premature infants. Methods This randomized controlled clinical trial was carried out on 66 mothers with hospitalized neonates in the NICU of Alzahra hospital in Tabriz- Iran. Participants were randomly allocated into two groups of intervention (n = 34) and control (n = 32) through a block randomization method. The intervention group received 6 sessions of supportive counseling (45–60 minutes each session) by the researcher, and the control group received routine care. Questionnaires of Goldberg General Health and the postpartum bonding were completed before the intervention (first 72 hours postpartum) and 8 weeks postpartum. Also, the anthropometric index of newborns were measured at the same time. Results There was no statistically significant difference between the two groups in terms of socio-demographic characteristics. After the intervention, based on ANCOVA with adjusting the baseline score, mean score of mental health (AMD: -9.8; 95% Confident Interval (95% CI): -12.5 to -7.1; P
... 1. Physical injury to the baby and resulting psychological distress, and/or 75 2. Physical injury to the mother which results in psychological distress, and/or 3. Fear of physical injury to mother or baby and associated psychological distress, and/or 4. Psychological response to the experience of birth, including care received, which causes psychological distress of an enduring nature ...
https://hydra.hull.ac.uk/resources/hull:17083
Background: A significant number of women experience childbirth as traumatic, with long-term negative sequelae. Little is known about the choices women make in subsequent pregnancy(s)/birth(s). Understanding the choices women make, and why, is necessary to offer appropriate support to women traumatised by their previous birth(s).
Question: What choices do women make in the perinatal period, when they have previously experienced a traumatic birth?
Method: Nine pregnant UK-based women who had previously experienced a traumatic birth were recruited to a longitudinal feminist grounded theory study, via online pregnancy and parenting forums. Interviews were carried out in early pregnancy, pre-birth, and postnatally (27 interviews).
Results: Findings suggest that women gathered and analysed information from a variety of sources, often at an early stage (even pre-conception) to make choices about birth. Women made decisions throughout pregnancy in order to have the birth they wanted.
Participants expressed difficulty in trusting healthcare professionals because of their previous experiences, and needed recognition that trust had to be rebuilt. Each woman located the power to support her birthplan in someone different. Anticipating a lack of support for their plans, women prepared for appointments as though each would be a battle. When each woman met the person whom she believed could agree her choices, if they offered support for her plans, she experienced relief. If that support was denied, it was devastating.
If women were able to develop trusting relationships with healthcare professionals during pregnancy, this birth was likely to be a positive experience. Similarly, support from partners was an indicator for a positive birth experience.
Conclusions: This thesis explores relationships between women, information, birthplans and trust, and proposes a care pathway for women who have previously experienced a traumatic birth. The care pathway advocates continuity of care from a single appropriate carer, who provides information, and supports the early formulation of a birthplan.
... charities) also have an important role in helping support parents in the perinatal period (NHS, 2014). Third sector organisations offer support to parents through various practitioners such as parent educators who facilitate parenting information and support (Ayers & Delicate, 2016); doulas who provide non-clinical birth and postnatal care (Simkin, 2011); peer supporters who are parents trained to help other parents (McLeish & Redshaw, 2017); and lactation specialists who assist parents with infant feeding (Thurman & Allen, 2008). ...
Background: Childbirth can be physiologically traumatic and has been shown to effect parental wellbeing. Whilst understanding has grown about the prevalence and impact of birth trauma on parents, less is known about the views of the healthcare practitioners who support parents.
Aims and Objectives: The present study aimed to investigate practitioners’ perceptions of birth trauma, their observations of its impact on parents and experience of the support parents require.
Method: The study was conducted using the Qualtrics online survey platform. A survey was developed to measure practitioners’ perceptions of the rate of parents affected by birth trauma, observed symptoms, availability and effectiveness of support. Recruitment took place via social media in 2018 of UK practitioners working with parents in the first-year post birth. 152 practitioners completed the survey (health visitors n=42; midwives n=51; and non-NHS parent supporters n=59).
Results: Participants reported very little screening for birth trauma and it was mostly informal and lacking for partners. Perceived birth trauma was 33.9% for mothers and 24.8%for partners. Most commonly observed birth trauma symptoms were re-experiencing in mothers (88.3%) and avoidance in partners (69.2%). Most frequently offered support was personally listening to the couple (93.8%) referral to birth listening services (74.2%) and signposting to self-help resources (52.6%).
Interpretation / Discussion: Thematic analysis of open text responses to questions on how to support couples following birth trauma showed that practitioners thought support for birth trauma could be improved by 1) prevention of birth trauma, 2) raising awareness and knowledge, 3) improvements in identifying those in need of support and 4) enhanced supply of suitable support.
Conclusions: Despite a lack of screening, practitioners are perceiving parents to be affected by traumatic birth and identifying a range of symptoms. There appear to be gaps in the provision and accessibility of support services for birth trauma for which practitioners give useful insight.
... This also increases the risk of PTSD (Volpicelli, Balaraman, Hahn, Wallace, & Bux, 1999). Trauma history in the past such as childhood trauma history, sexual harassment, partner violence, and negative experiences that the women experience during prenatal and labor/childbirth may cause women to have childbirth trauma and PTSD (Beck, 2004;Simkin, 2011). Evidence confirms widely the relationship between the aforementioned factors and postpartum PTSD (Cigoli et al., 2006;Cohen, Ansara, Schei, Stuckless, & Stewart, 2004;Creedy, Shochet, & Horsfall, 2000;S€ oderquist, Wijma, & Wijma, 2002). ...
Objective: The present study evaluates the traumatic perception of the birth phenomenon in women with substance-use disorders (SUD) and to investigate the effects of psychoeducation on this perception. Material and Methods: The study was conducted between January and July 2017, and involved 60 women with SUD who were divided into two groups: intervention (n = 30) and control (n = 30). The study was carried out using the semi-experimental “pre-post test matched group model,” and the Traumatic Perception of Birth Psychoeducation Program (TPBPP) was applied. Results: Traumatic birth perception was found to be decreased after TPBPP was applied in four modules to women with SUD. Conclusion: TPBPP is an effective psychoeducation model in the reduction of the traumatic perception of birth in women with SUD.
... 8 Although the benefits of the first hour for babies have been proven, unfortunately, its benefits for mothers, especially for mothers' mental qualities have not received due attention. This is while childbirth is an important and potentially a traumatic event for pregnant women, 10 and it is among the most intense emotional experiences in a woman's life that provokes emotions, excitement and mental symptoms which can be caused by trauma. 11,12 A lot of studies have also been conducted on the impact of postnatal depression on lactation, [13][14][15] but few studies have been carried out on the impact of early skin to skin contact and breastfeeding on preventing postnatal depression. ...
Introduction: the implementation of the baby’s nine instinctive stages as a sacred hour after birth is very effective in starting breastfeeding. About half of newly delivered mothers have reported a traumatic childbirth experience often associated with mental health problems. The present study aimed to examine the effect of the sacred hour on the depression in traumatic childbirths. Methods: In this clinical trial, 84 mothers who had experienced a traumatic childbirth were randomly allocated into the intervention (n = 42) and control (n = 42) groups. The intervention group received sacred hour (baby’s nine instinctive responses), but the control group received only the routine care. Postnatal depression was evaluated as primary outcome at 2 week, 4-6 week and 3 month intervals after the delivery. The data were analyzed using t test, chi-square test and the repeated measures analysis of variance. Results: The results showed that the marginal total mean (SD: standard deviation) scores of depression in the intervention and control groups were 7.5 (2.6) and 9.6 (2.6); therefore, the mean difference (95% CI) between the groups (-2.1, (-3.2,-0.95)) was significant. Conclusion: The implementation of the sacred hour is recommended as a preventive approach to reduce the postnatal depression in women with a traumatic childbirth experience.
... Childbirth is an important and potentially traumatic event. 1 There is now substantial evidence that women can suffer from a range of psychological problems during this time. [2][3][4] According to DSM-V-A, a trauma is a stressful event in which a person experiences a feeling of threat, injury, or death for himself/herself or one of his/her loved ones. ...
Introduction: Childbirth is a stressful event in every woman's life, leading to traumatic deliveries in half of the cases. This study aimed at describing mothers’ lived experiences which make them perceive their childbirth as traumatic.
Methods: In this descriptive phenomenological study, based on the DSM-V-A criteria, 32 mothers who had perceptions of a traumatic event during their labor and delivery were explored through semi-structured interviews, and the collected data were analyzed using the Colaizzi’s method.
Results: Four main themes could be extracted from the experiences of the mothers. The first theme was sensational and emotional experiences followed by clinical experiences, legal experiences and human dignity, and environmental experiences. The sensational and emotional experiences included four main categories (anxiety, fear, sorrow, anger). The theme of clinical experiences included two main categories (avoidable and unavoidable childbirth complications). The theme of legal experiences and human dignity included two main categories (non-observance of the charter of patient rights, and non-observance of human rights). The theme of environmental experiences also included two main categories (lack of proper supervision and management).
Conclusion: To prevent traumatic childbirth and its negative effects, different psychological aspects of childbirth need to be identified.
... The absence of pain does not mean absence of negative emotional reaction or suffering (Simkin & Hull 2011). When women have a negative birth experience, they may develop childbirth related posttraumatic stress syndrome. ...
... When women have a negative birth experience, they may develop childbirth related posttraumatic stress syndrome. According to Lally et al (2014), midwives should recognize that, if a woman has any option of pain relief, she still needs professional support that enhances labour progression (Simkin & Hull 2011;Lally et al. 2014). Simkin and Hull for labour and minimize the likelihood of loneliness, disrespect and intolerable pain. ...
... In other words, women's constructions of midwives' attitudes and behaviour towards them reflect their views of how they perceived they were treated as opposed to physically what happened to them. The further finding that women lacked confidence in their midwives, being related to either the midwife's competency or level of control in the situation, reflect that women need to rely on and trust their midwives at a time of vulnerability (Briscoe, Lavender, & McGowan, 2016;Simkin & Hull, 2011). These assertions are strengthened by the finding that an unmet desire for support was a significant factor predisposing the development of PTSD-PC. ...
Objective: Review primary research regarding PTSD Post-Childbirth (PTSD-PC) that focussed on Quality of Provider Interaction (QPI) from the perspective of women who developed PTSD-PC, or midwives.
Background: Up to 45% of women find childbirth traumatic. PTSD-PC develops in 4% of women (18% in high-risk groups). Women’s subjective experiences of childbirth are the most important risk factor in the development of PTSD-PC, with perceived QPI being key.
Methods: A systematic search was performed for PTSD-PC literature. Reviewed papers focussed on either women’s subjective childbirth experiences, particularly QPI, or midwives’ perspectives on QPI. Study quality was assessed using the Critical Appraisal Skills Programme (CASP) tools, and a narrative synthesis of findings produced.
Results: Fourteen studies were included. Three features of QPI contribute towards developing PTSD-PC: interpersonal factors; midwifery care factors; and lack of support.
Conclusion: QPI is a significant factor in the development of PTSD-PC and the identified key features of QPI have potential to be modified by midwives. The development of guidelines for midwives should be grounded on evidence highlighted in this review, along with further high-quality qualitative research exploring QPI from the perspective of women with PTSD-PC, but also midwives’ knowledge and needs regarding their role within QPI.
