Childbirth Trauma and Its Effect on Breastfeeding

The title of the article is incomplete; it tells the reader the key phenomenon covered in the article i.e. childbirth trauma and its effect on breastfeeding. According to Polit and Beck (2006) a good qualitative research article title should describe the phenomenon and a group or community. However, this study does not specify the study population. Thus, the title is not complete as information about study population is lacking.

The article summarizes the studys background, aim, methods, results, and conclusion. An abstract should describe, in concise terms, the various aspects covered in the article (Polit& Beck, 2006). From the abstract, the reader gets an idea of the studys purpose and content areas, the study design, results obtained (major themes) and conclusions. The abstract also maintains the characteristics of the study subjects and the data analysis approach used. The abstract identifies the key words contained in the body of the article but does not define them.

Statement of the Problem
In the article, the problem statement is clearly and easily identifiable by the reader. Many organizations have implemented interventions to overcome barriers to successful breastfeeding, but not one of these interventions addresses the impact of traumatic childbirth on breastfeeding (Beck & Watson, 2008, p.231). Moreover, the problem statement is unambiguous; it explicitly describes the problem (traumatic childbirth) and its impact on breastfeeding.

Persuasive argument for study
The problem statement is also persuasive; using evidence from relevant studies, the authors convincingly argue that traumatic childbirth is a potential risk factor for delayed lactogenesis (Beck & Watson, 2008, p. 228). The statement seems persuasive.

Significance to nursing
The problem has significance in nursing; support by nurse midwives can decrease birth trauma, hence address the barriers to breastfeeding. Knowledge on the impact of birth trauma on breastfeeding based on subjective information obtained from mothers has significance to nursing. It will help nurses to give an effective and holistic care to mothers experiencing delayed lactogenesis due to traumatic childbirth.

The researchers also show a clear connection between paradigms and research problem. The authors describe traumatic childbirth (problem) in a broad way and give different birthing practices that cause trauma. The broad description of the term traumatic childbirth in this article ensures that the research problem matches with the model (Garrard, 2011). Also, the studys phenomenological research method matched with the research problem; the researchers collected and analyzed written statements collected from the participants and then identified main themes that described the subjects experiences (Beck & Watson). The themes represented the participants views on the research problem.

Research Question
In the study, the research question is clear: What is the essence of womens breast-feeding experiences after a traumatic childbirth? (Beck & Watson, 2008, p.233) In this research question, the various aspects of the research problem are explicit and consistent with the studys conceptual framework. The researchers set out a clear and focused conceptual framework on the risk factors of birth trauma and how this impacts breastfeeding. They derive the research question from this conceptual framework.

Adequacy of summary of existing body of knowledge
The authors included enough sources in the literature review section. They included 15 major articles (peer-reviewed) and one report with relevant content on the topic. Primary sources are important sources of information for research (Rolfe, 2006); they are reliable, original and have a small time gap. The researchers summarized key concepts and theories from the literature review.Based on past studies, the researchers define birth trauma, describe global perspectives and risk factors for birth trauma and discuss birthing practices that affect breastfeeding.

Justification for the study
The researchers identify gaps in literature that needs to be explored.. Also, by describing the various concepts and theories, they refine and clarify the studys perspective. According to Polit and Beck (2006, p.122) a good literature review should clearly and concisely analyze earlier studies on the topic and connect it to the present research. They state that past studies mainly focus on physiological measures associated with breastfeeding. This forms the basis for conducting this study. The researchers state that a gap in the literature exists and thus this qualitative study examined the mothers descriptions of how their traumatic childbirth affected their breastfeeding (Beck & Watson, 2008, p.229). They explore this perspective to gain new insights into this topic.

Conceptual Framework
Description of Key Concepts
The researchers give definition for each concept identified in the study. They describe birth trauma, traumatic symptoms and risk factors associated with childbirth, and birthing practices that cause trauma. The epistemological tradition employed is clear. The researchers use phenomenology, which is right for examining life experiences and how they affect the participants (Polit& Beck, 2006). This approach enabled the researchers to describe the relationship between traumatic birth and unsuccessful breastfeeding.

Method
Protection of Human Rights
Institutional review boards (IRBs) approve projects involving human subjects. The study involved an internet sample consisting of 52 mothers (Beck & Watson, 2008, p. 230) who had experienced physical or emotional trauma or both during childbirth. The researchers selected eligible subjects based on specific inclusion criteria. The project gained the approval of the universitys IRB before commencement. This protected the participants rights or welfare particularly the right to privacy (confidentiality) and anonymity. There is no mention of whether or not the project gained approval from an external entity to assess its procedures and methodologies.

Minimum risk/ Maximum benefit
For a project to gain IRBs approval its benefits must outweigh the risks. The researchers first informed the participants of the study via a post on Trauma and Birth Stress (TABS) website, and before seeking an informed consent (a story on childbirth experience). Through informed consent, the researchers were able to decreased emotional risks. Furthermore, the communications between the researcher and the participants was also confidential to avoid psychological risks associated with their birth trauma. The studys design had many benefits to the participants; it helped them understand how the traumatic birth experience may impede breastfeeding. Its purpose was to give support to mothers who experienced traumatic childbirth and educate the public on post-traumatic stress disorder caused by childbirth trauma (Beck & Watson, 2008, p. 228). Thus; the studys benefits outweighed the risks.