Women's choices about pregnancy and birth, subsequent to a traumatic birth.

My research investigates the choices pregnant women make when they have previously had a traumatic birth. It is relevant to academics working in midwifery education, obstetrics, social policy, psychology, and sociology, and has implications for midwives and obstetricians in practice. This fellowship will enable me to publicise the findings of my research, and to carry out a small study into an issue which arose during my doctoral research.

Traumatic birth is an emerging area of research. Up to 30% of women in the UK experience childbirth as a traumatic event, with many going on to experience some form of anxiety, depression, or post-traumatic stress disorder (PTSD) following childbirth (Slade, 2006; Ayers, 2014). Research does exist into why some women experience childbirth as traumatic, and how it can be treated, but there was no research into how a traumatic birth might affect the choices women made in subsequent pregnancies. My research showed that these women might make less usual birth choices, from elective caesarean births to 'freebirths' (choosing to birth without a midwife or other medical professional present), and that they researched these choices very carefully. It also showed that these women benefitted from certain kinds of care, including continuity of carer, and making a birth plan early in their pregnancy.

To reach the largest audience, I will publish my findings in three ways - through peer reviewed articles, at conferences, and in publications aimed at a lay audience. The themes of the articles and conference presentations will be related:
- Birth plans for women who have previously had a traumatic birth
- Relationships between women and midwives after a traumatic birth

The journals that I publish my articles in and the conferences I present my findings at will be chosen to create the biggest impact possible, and to cross academic disciplines. My research also used an unusual methodology, and a further article about how I dealt with the challenges of this will be published.

The triennial International Midwives Confederation (ICM) conference is in summer 2020. The 2017 ICM conference was attended by over 4,500 people, from 113 countries. I will apply to run a workshop developing midwives skills in working with women affected by traumatic births, creating a great opportunity for my research to achieve a high impact.

As well as publicising my findings to academics and professionals, I want to tell parents what I found. I will reach a wide audience of parents by using social media (for example Facebook and Twitter), and by writing a blog about my research. During the fellowship I will also draft some early plans for a book for parents, about pregnancy and birth after a previous traumatic birth.

One purpose of this bridging Fellowship is to enable me to move into a post-doctoral academic career, and I would therefore develop external funding proposals during the fellowship. At this time I am interested in developing proposals relating to the areas of:
- Lesbian women's experiences of traumatic birth
- Freebirth
- Independent Midwifery

In my doctoral research, three women considered 'freebirthing' (birthing without a midwife present). There has been a recent surge in media attention to freebirth, but no UK-wide data is collected. Adding to the confusion, the term is sometimes used to refer to situations where:
- women choose not to have a midwife present
- women want a midwife, but an appropriate service is not available
- misjudgements of services required (for example when a baby is born before the arrival of a midwife at home, or where a baby is born enroute to a hospital).

As part of this fellowship I would design and carry out a scoping review to identify the most pressing questions that research could answer about 'freebirth'. This review would also include defining the term 'freebirth', distinguishing the different reasons women might give birth without a midwife.