“Not just a normal mum”: a qualitative investigation of a support service for women who are pregnant subsequent to perinatal loss

Abstract

BackgroundFollowing previous perinatal loss, women in a subsequent pregnancy may experience heightened emotions, such as anxiety and fear, with a range of longer-term implications. To support these women, the Mater Mothers’ Bereavement Support Service in Brisbane, Australia, developed a Pregnancy After Loss Clinic (PALC) as a specialised hospital-based service. The present study investigated the experiences of mothers with previous perinatal loss in relation to: (a) their subsequent pregnancy-to-birth journey, and (b) the PALC service. Such research seeks to inform the ongoing development of effective perinatal services.MethodA qualitative interview-based research design was employed with a purposive sample of 10 mothers who had previously experienced perinatal loss and who attended the Mater Mothers’ PALC during their subsequent pregnancy in 2015. All mothers had subsequently delivered a live baby and were in a relationship with the father of the new baby. Women were aged between 22 and 39 years, primiparous or multiparous, and from a range of cultural backgrounds. Semi-structured interviews, conducted either at the hospital or by telephone by an experienced, independent researcher, lasted between 20 min and one hour. All interviews were audio-recorded and transcribed verbatim, with participant names changed. Interviews were analysed using content analysis by two researchers who were not involved in the service delivery or data gathering process.ResultsSeven themes were identified from the interview material: The overall experience, The unique experience of first pregnancy after loss, Support from PALC, Experiences of other services, Recommendations for PALC services, Need for alternative services, and Advice: Mother to mother.ConclusionsParticipants spoke positively of the PALC services for themselves and their families. Anxieties over their subsequent pregnancy, and the desire for other health professionals to be more understanding were frequently raised. Recommendations were made to extend the PALC service and to develop similar services to support access for other families experiencing perinatal loss.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-1200-9) contains supplementary material, which is available to authorized users.

Post-traumatic stress and related symptoms in a gestation after a gestational loss: narrative review

“…The women repeatedly expressed doubts about their physical ability to maintain a successful pregnancy. In some cases, this "distrust" provoked requests for intervention (Lisy, Peters, Riitano, Jordan, & Aromataris, 2016;Meredith, Wilson, Branjerdporn, Strong, & Desha, 2017;Mills et al, 2014;Wojcieszek et al, 2016).The meta-analysis performed by Hunter et al (2017) concludes a significant mean effect of perinatal loss on the increase of anxiety levels in women during subsequent pregnancies. Higher levels of depression and anxiety have been observed in women who conceive quickly after a perinatal loss.…”

Women’s Lived Experience of Embodied Disenfranchised Grief: Loss, Betrayal, and the Double Jeopardy

“…Thus, what was public now reverts to the private arena. Tension can ensue, the "elephant in the room" that everyone can see but no-one acknowledges (Mills, et al, 2016;Campbell-Jackson, et al, 2014;Meredith, et al, 2017;Heazell, et al, 2016). For women whose losses may not be acknowledged by society (for example, ectopic pregnancy and non-medical elective termination of pregnancy) these silences may be especially difficult to cope with.…”

“…Some may deny the existence of the current pregnancy, or delay announcing the pregnancy to family and friends until the perceived danger time has passed (Ockhuijsen, Boivin, van den Hoogen, & Macklon, 2013). For others, the unanticipated grief that resurfaces in the current pregnancy can interfere with attachment to the unborn baby, bringing with it an emotional distancing from foetus/baby and a life-long impact on the subsequent child (Meredith, Wilson, Branjerdporn, Strong, & Desha, 2017;O'Leary, Warland, & Parker, 2012;Bowlby, 1989). The loss of the previous baby signifies a loss of innocence.…”

“…Many women highlighted their dissatisfaction and frustration with the maternity care they received. Women felt that to be treated as any other mum denied the impact that the previous loss had on them, and argued that their care should be individualised to reflect this (Meredith, et al, 2017). Mills et als study (2016) identified allocation of care professionals, parent education and birth preparation as lacking in providing appropriate support and content to support women's needs.…”

“…The naivety upon which the previous pregnancy was embarked is gone, with the parents now knowing that there is never a guarantee of a healthy baby. Furthermore, a loss of trust occurs in their body's ability to nurture and maintain a successful pregnancy, with the resultant fear of a recurrence of further pregnancy loss (Meredith, et al, 2017;Meaney, Everard, Gallagher, & O'Donoghue, 2016).…”