Enhancing woman-centred care for pregnant women who have experienced a previous traumatic birth: An Australian Modified Delphi Study

Childbirth is often characterised as a time of joy. However, some women have a traumatic birth experience, resulting in ongoing psychological symptoms of distress. This can affect women's mental and physical health in subsequent pregnancies; however, a woman-centred approach has the potential to heal. This study aims to design a means to identify and determine the elements important to creating a woman-centred care pathway in the next pregnancy. A modified Delphi study was undertaken, informed by a scoping review that identified common needs and care gaps for women with a traumatic birth experience. An expert panel was purposively recruited in Australia, comprising women with traumatic birth experience (n = 9) and multidisciplinary health care professionals (n = 9). Over four iterative online rounds, questions and proposals on developing a screening tool and elements to improve women's care experience were put to the panel. Consensus was agreed at 75 % of aligned votes. Qualitative data were analysed using content analysis. A screening tool was developed by consensus incorporating a question on women's previous birth experience and a validated tool on fear of birth. Eleven elements that would facilitate a woman-centred approach following a traumatic birth were identified, and a woman-centred individualised maternity care planning guide was co-designed. The modified Delphi process achieved consensus on a care pathway to identify women early in their subsequent pregnancy and a woman-centred individualised maternity care planning guide. A proof-of-concept of this woman-centred pathway will be tested in an antenatal clinic setting in Melbourne, Australia.