Content of review 1, reviewed on June 01, 2021

Title reflects what the paper is about.

The abstract is in depth and clearly states the study aim, background, methods and results in brief. References are up to date and relevant including current recent guidelines and other 'key' texts and authors. Gives a good overview of the current research in birth trauma, birth trauma sequelae including PTSD, and also the lack of information on decision making in subsequent pregnancies. The research question is justified and appropriate

Inclusion of reflexive statement is positive.

Inclusion/Exclusion criteria are clear and appropriate.

I have questions about the study group - over half (of 9) had PTSD/PND diagnoses. No mention of previous birth, but the assumption is it was traumatic.

Discussion indicates that early birth planning is important - how early? The introduction states that women are entitled to free midwifery perinatal care from conception. This may be true, but anecdotal reports indicate that women are often unable to access midwifery care until a set gestation - usually around 8 weeks.

Conceptual categories are presented in a table. Remaining results are presented as text. Text is meaningful and forms the full basis of the results section.

Well rounded discussion which set the findings against what we know about access to current midwifery services, the way in which birth is approached for the first time by many women, and implications for practice for midwifery for women planning subsequent pregnancies following birth trauma. Limitations are not fatal, and qualitative research may be less generalisable than exclusively quantitative data analyses. Points to further research (fits nicely with my PhD!?)

Improvements which could be made: 1. There is no information on grounded theory research and why this was chosen, particularly as a longitudinal study design which has been rarely used?

  1. In a longitudinal study, can data saturation be achieved at one time point, and there be no new data, or no new identified themes at later time points?

  2. No mention of how the interviews were recorded and whether non verbal information was part of the dataset. No mention of specifics of how the interviews were transcribed (i.e. clean verbatim).

  3. I find the figures harder to read than I would have liked as I read the keys differently to the way in which they are set out/the authors intended. Although manageable there may have been a different way to present these. But this might just be my personal preference. Again, Qualitative data findings are often much more text heavy. May have been useful to have demographic data presented as a table as the results section is text heavy.

  4. Themes don't emerge - See Braun and Clarke 2019 Reflecting on Reflexive Thematic Analysis

  5. A statement is made about women feeling they need to fight to be able to make their own choices, which isn't supported with any quotations, this could have been changed.

  6. Little mention is made of external support services (Doula, Charities) although these were some of the places used for recruitment of women to the study, and how these might be utilised by women seeking support and information outside the NHS, other than just the Internet which is quite a broad field. Perhaps women didn't speak in specifics of where they felt able to look for support?

Source

    © 2021 the Reviewer.

References

    Mari, G., Julie, J., Lesley, G. 2019. "It Can't Be Like Last Time" - Choices Made in Early Pregnancy by Women Who Have Previously Experienced a Traumatic Birth. Frontiers in Psychology.