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Midwives' experiences of caring for women with early pregnancy loss in an Irish maternity hospital

02 December 2018
20 min read
Volume 26 · Issue 12

Abstract

Background

Midwives provide care for women experiencing early pregnancy loss, as well as support for women throughout childbirth. Research has predominately focused on women's experience of early pregnancy loss, with little research on how such loss affects midwives and care provision.

Aim

To explore the perceptions of midwives caring for women experiencing early pregnancy loss.

Methods

This study used a descriptive qualitative design with semi-structured interviews. A purposive sample of eight midwives, all of whom had relevant experience, were recruited from a maternity hospital in Ireland.

Findings

Themes identified were: ‘coping with the experience of early pregnancy loss’, ‘compassionate care for women and midwives’, and ‘what midwives found difficult’.

Conclusions

Repeated exposure to early pregnancy loss can have a profound emotional effect on midwives, with a potential for this to affect the care that women receive. Midwives identified the need for further education in the area of early pregnancy loss, time out during the shift to debrief, and counselling for staff. Structured support is needed for midwives and other health professionals where there is repeated exposure to early pregnancy loss.

Childbirth is considered a major highlight in human life (Bennett et al, 2008), but early pregnancy loss occurs more frequently than many realise. The loss of a pregnancy before 13 completed weeks is referred to as ‘early pregnancy loss’, ‘miscarriage’ or ‘spontaneous abortion’ (American College of Obstetricians and Gynaecologists, 2015). Early pregnancy loss accounts for over 50 000 annual hospital admissions in the UK and 15-20% of confirmed pregnancies are reported to end spontaneously in the first trimester, according to the National Institute for Health and Care Exellence (NICE) (2012). In Ireland, there is a reported early pregnancy loss rate of 20%, with approximately 14 000 women affected annually (The Miscarriage Association of Ireland, 2010). In maternity hospitals in Ireland, as in other parts of Europe, midwives are the main caregivers for women experiencing a miscarriage. There are limited evidence-based practice recommendations to guide the care of women experiencing early pregnancy loss, and very little is known of the experience of midwives as care providers for those who are bereaved (Gergett and Gillen, 2014). When health professionals experience difficulties supporting or connecting with women or couples, this can sometimes result in focusing on what is strictly necessary in terms of technical care (Camarneiro et al, 2015), potentially detracting from the care, compassion and empathy that people in their care need.

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