Women's experiences of trauma-informed care in midwifery and maternity services and implications for maternal wellbeing: A qualitative systematic review.

INTRODUCTION

Trauma-informed care has been increasingly advocated within maternity services as an approach to promote safety, autonomy, and respectful care. However, qualitative evidence exploring how participants experienced trauma-informed care across maternity and midwifery services has not been systematically synthesized. This review therefore aimed to synthesize qualitative evidence on women's experiences of trauma-informed care across maternity services, including midwifery care, during pregnancy, childbirth, and the postpartum period.

METHODS

A systematic review was conducted in accordance with PRISMA 2020 and ENTREQ guidelines. Five electronic databases (PubMed, Scopus, Web of Science, CINAHL, and PsycINFO) were searched for peer-reviewed qualitative studies published in English. Eligible studies explored women's experiences of trauma-informed, trauma-sensitive, or related care practices within maternity settings. Data were synthesized using thematic synthesis, and methodological quality was appraised using the CASP qualitative checklist.

RESULTS

Fifteen qualitative studies were included. Four analytical themes were identified: 1) creating safety and preventing re-traumatization; 2) respectful communication and informed consent; 3) emotional validation, trust, and relational attunement; and 4) power, control, and women's agency in maternity care. Across studies, trauma-informed care was experienced not as a discrete intervention but as a relational approach embedded in everyday maternity practices.

CONCLUSIONS

Women's experiences suggest that trauma-informed principles may contribute to positive care experiences and support psychological safety, autonomy, and relational wellbeing across the perinatal period, when embedded within routine midwifery and maternity practice.