Routine discussion of previous trauma in the perinatal period: Insights from interviews with women, voluntary sector representatives, and maternity care providers

Background Many pregnant women have a history of trauma, such as abuse or violence, which can significantly impact their mental and physical health. Discussing these experiences in maternity care presents an opportunity to support women, reduce stigma, and connect them with resources. However, concerns persist about stigmatisation, re-traumatisation and unwarranted safeguarding referrals. As part of a larger study that aimed to develop a methodology for conducting trauma discussions, interviews were carried out with a range of stakeholders. Methods Semi-structured interviews were conducted with women with trauma histories (experts by experience; n=4), representatives of voluntary sector organisations (n=7), and healthcare providers (n=12). Reflexive thematic analysis was used to analyse the data. The study employed a critical participatory action research approach, supported by a Patient and Public Involvement & Engagement group (named as the Research Collective for this study) comprising experts by experience, maternity care professionals, and voluntary sector practitioners. The group contributed to both the design and analysis phases of the research. Findings Five key themes emerged from the interviews, exploring both the benefits and challenges of trauma discussion in maternity care. Participants reflected on who should lead these discussions, the appropriate settings and timings, and strategies for effective communication. The emotional and training needs of care providers conducting trauma discussions were also highlighted. Conclusion Trauma discussions in maternity care are a complex but necessary intervention that require careful consideration of timing, communication, and referral pathways. This paper offers concrete steps towards creating a more empathetic and supportive maternity care environment.