A systematic review of nonpharmacological interventions to improve trauma symptoms and mother–infant bonding for women who experience birth trauma

INTRODUCTION: Childbirth trauma affects a significant number of women and their families worldwide, with a broad range of prevalence estimations in Australia from 28% to 45%. Birth trauma has been found to influence the early mother-infant relationship. The role of occupational therapy within the perinatal context is emerging, although evidence of occupation-based interventions for women following birth trauma is sparse. This study aimed to (1) synthesise the literature on non-pharmacological interventions that address both childbirth-related trauma symptoms and the mother-infant relationship and (2) summarise the reported efficacy of the interventions on reducing trauma symptoms and improving the mother-infant relationship. METHODS: Six databases were searched in December 2024. The search retrieved 1532 results, and after duplicate removal, 1476 articles were retrieved, and ultimately six articles were included. The quality of the included studies was appraised for methodological quality according to the Cochrane handbook for assessing risk of bias. Data were extracted in January 2025 and included information on study locations, design, participants, time between childbirth and recruitment, intervention and outcomes, key findings, and limitations. CONSUMER AND COMMUNITY INVOLVEMENT: This systematic review involved no consumer or community involvement. RESULTS: Six studies met inclusion criteria. None of the retrieved studies trialled occupation-based interventions. Psychology and midwifery were the most represented groups in the intervention design and delivery. A range of outcome measures and timepoints were used. Both mother-infant bonding and trauma symptoms improved over time across the intervention and control groups. Evidence was limited to support any specific intervention for trauma symptoms or mother-infant bonding following birth trauma. CONCLUSIONS: Birth trauma is an emerging field of research. From an occupational therapy perspective, there is a scarcity of evidence on interventions that are designed around occupational participation or mother-infant co-occupation. Further research into occupation-based support for women after birth trauma is recommended.