Methods
ELIGIBILITY CRITERIA
This review included both quantitative and qualitative studies to give a
holistic overview of the literature. Studies from 1990 onwards were
included, as research into PTSD following childbirth first started in
this decade . This review included studies which explored PTSD in women
who gave birth by different modes of birth as described in the
introduction.
For quantitative research, studies were included if participants
included women who had given birth within 6 months prior to recruitment
to a live singleton infant carried to term in high-income countries as
classified by the World Bank . Qualitative studies were included if
participants were either postnatal women who met the criteria as above,
or people who supported these women. This category included husbands or
partners, friends, family, peers, support groups and healthcare
providers.
SEARCH STRATEGY
The protocol for this review was registered on the PROSPERO
International Prospective Register of Systematic Reviews
(CRD42018089132). Searches were conducted in CINAHL, the Cochrane
Library, MEDLINE, PsycINFO and Scopus on the 20thMarch 2018, and an update search was performed on the
25th October 2019. There were two searches run in each
database: one for quantitative studies and one for qualitative studies.
Reference searching was performed in relevant reviews identified by the
searches. Full search strategies can be seen in appendices S1-S2 .
STUDY SELECTION AND DATA EXTRACTION
Abstract screening was undertaken, followed by full-text assessment by
JC and Y-SC. Papers which met eligibility criteria were included. If a
paper did not explicitly state these criteria, authors were contacted
via email.
A data extraction form was created for quantitative and qualitative
studies. From quantitative studies, the data extracted included
incidence of postnatal PTSD for women who underwent different modes of
birth in the form of Odds Ratios comparing the mode of birth studied
with SVD where possible. For the qualitative studies, key findings (i.e.
themes) were extracted.
QUALITY APPRAISAL
Quality was assessed by JC and Y-SC using the Newcastle-Ottawa Scale
(NOS) for quantitative cohort studies, the Centre for Evidence Based
Medicine (CEBM) Critical Appraisal Checklist for cross-sectional studies
and the Critical Appraisal Skills Programme (CASP) tool for qualitative
studies.
OUTCOME MEASURES