“Getting it right when it goes wrong – Effective bereavement care requires training of the whole maternity team”

Aggarwal, Neelam; Moatti, Zoe

doi:10.1016/j.bpobgyn.2021.10.008

Cited by 6 publications

(4 citation statements)

References 58 publications

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“…Attention to grief is an area of great need, a relatively little travelled road. Although the loss cannot be undone, the negative impact can be reduced by compassionate supportive care [50] as in the rituals of seeing the infant, saying goodbye, holding the baby, and gathering memories [45,51,52]. In addition, this involvement of the father has the positive effect of creating a bond with the infant that he had never seen or felt inside himself [53,54].…”

Section: Discussionmentioning

confidence: 99%

Sexuality and affectivity after a grieving process for an antenatal death: a qualitative study of fathers' experiences

2023

Journal of Men's Health

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The loss of an infant at the prenatal stage is one of the most traumatic events parents can experience. Prenatal losses have several negative implications for parents’ physical, psychological, and social well-being, including intimacy and sexuality. Fathers who suffer from this experience have to cope not only with their grief, but also with the physical and emotional suffering of their partners. The social context gives the father a masculine role of strength, insensitivity, and protection of the mother, with the result that his pain and grief become invisible. The objective of this study is to understand fathers’ experience of affective-sexual relationships after a grieving process for an antenatal death; A qualitative study based on interviews with 11 fathers in Spain who have experienced an antenatal death was conducted. Data were analyzed with the help of ATLAS.ti software to discover emerging themes. 6 sub-themes were developed from the analysis, grouped into two main themes: the invisibility of grieving fathers and the relationships between the grieving parents are influenced by the death of their infants. The sexuality of fathers who suffer an antenatal death is altered. Gender stereotypes and the lack of social and professional awareness make their grief invisible. Fathers need to express their emotions to cope with their own grief and break the stereotypical gendered bereavement. In most cases, the couple’s relationship is altered, from a close union to a more distant relationship, in addition to a decrease in sexual desire and arousal. However, other fathers experienced greater closeness and intimacy in the couple. A communication based on sincerity, exposing their own grief, feelings, emotions and needs could help the couple’s relationship.

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Section: Discussionmentioning

confidence: 99%

Sexuality and affectivity after a grieving process for an antenatal death: a qualitative study of fathers' experiences

2023

Journal of Men's Health

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“…Kain’s [ 44 ] study defined grief as a “pervasive, highly individualized, dynamic process”. Tanzanian midwives shared stories that emphasized the fact that grief is not linear or localized but rather temporal, drawing on individualized experiences in both the present and past while simultaneously discovering new possible outcomes [ 13 , 18 , 45 , 46 ]. Such resilience is potent; based on the midwives’ accounts of haunting sadness, some have found a way to continue in a profession that is demanding in terms of the “self” [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

“…Multiple factors can be considered when a midwife experiences the death of a newborn, including the need to counsel the grieving mother, the midwife’s own grief, compassion fatigue, posttraumatic stress, and other influences on the midwives’ psychological well-being, burnout, along with the subsequent impact of this phenomenon on the midwife’s psychological well-being [ 13 , 14 ]. Midwives in sub-Saharan Africa rarely have the time to grieve due to the almost continuous overwhelming patient workloads [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Silent Tears of Midwives: ‘I Want Every Mother Who Gives Birth to Have Her Baby Alive’—A Narrative Inquiry of Midwives Experiences of Very Early Neonatal Death from Tanzania

Becker¹,

Becker²,

Abeysekera

et al. 2023

Children

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Background: Midwives working in settings with limited clinical resources experience high rates of very early neonatal deaths. Midwives manage the impact of this grief and trauma almost daily, which may affect patient care and their own well-being. Research Aims: To explore how midwives are impacted by and cope with high rates of very early neonatal deaths. To document midwives’ insights and local solutions that may reduce very early neonatal deaths in limited resource settings. To document the stories of midwives in order to create awareness and garner support for midwives and their critical work in low resource settings. Methods: Narrative inquiry utilizing semi structured interviews. Twenty-one midwives with at least six months experience who had experienced or witnessed very early neonatal death were interviewed. Data were audio recorded and transcribed, and reflexive thematic analysis of transcripts was conducted. Results and Discussion: Three themes were identified: (1) deep sadness resulting from very early neonatal deaths leading to internal struggles; (2) use of spirituality, including prayer and occasional beliefs that unexplainable deaths were ‘God’s plan’; and (3) development of resilience by seeking solutions, educating themselves, taking accountability and guiding mothers. Participating midwives noted that inadequate staff and high caseloads with limited basic supplies hindered their clinical practice. Participants articulated that they concentrated on active solutions to save babies during labour, such as vigilant foetal rate heart monitoring and partogram. Further, reduction and prevention of very early neonatal death is a complex problem requiring multidisciplinary teams and woman-centred care approaches to address issues contributing to the health of mothers and their new-borns. Conclusions: Midwives’ narratives highlighted ways of coping with grief and deep sadness, through prayer, and further education of both mothers and fellow colleagues to achieve better antenatal and intrapartum care and outcomes. This study gave midwives an opportunity for their voices to be heard and to generate solutions or insights that can be shared with colleagues in similar low-resource settings.

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“…A study from rural areas of Pakistan highlights the importance of psychological intervention delivered by community-based primary health workers, and it has the potential to be integrated into health systems in resource-poor settings to address the perinatal depression [ 48 ]. Another study developed a framework of ‘doing no harm and how to put things right’ through the training of maternity staff in evidence-based bereavement care [ 49 ]. Such frameworks can be adopted and modified according to the local socio-cultural needs for the training of community based healthcare workers to address the mental health issues of bereaved women in Pakistan.…”

Section: Discussionmentioning

confidence: 99%

The unspoken grief of multiple stillbirths in rural Pakistan: an interpretative phenomenological study

et al. 2022

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Background Pakistan has the highest rate of stillbirth (30.6 stillbirths per 1000 total births) as compared to other South Asian countries. The psychological impact of stillbirths on bereaved women is well documented; however, there is a dearth of literature on lived experiences of women with multiple stillbirths in Pakistan. Objective The purpose of this research is to understand the lived experiences of women who had multiple stillbirths in Thatta, Pakistan. Methods An interpretative phenomenological study was conducted in district Thatta with eight women who experienced more than one stillbirth. A semi-structured in-depth interview guide was used for data collection. The data were analyzed by using thematic analysis approach. Results The results of this study show that experiencing multiple stillbirths has a devastating impact on women’s mental and social wellbeing. The women who experienced multiple stillbirths are stigmatized as “child-killer” or cursed or being punished by God. They are avoided in social gatherings within the families and community, because of these social pressures these women seek spiritual and religious treatment, and struggle to conceive again to deliver a live baby. It was observed that the psycho-social and medical needs of these bereaved women remain unaddressed not only by the healthcare system but also by the society at large. Conclusions The physical, social and mental well-being of women who experience multiple stillbirth are at stake. These women are being considered social outcast. Health care providers including physicians, lady health workers, and traditional birth attendants should be trained on provision of psychosocial support along with the routine care that they provide in communities and health facilities. The health care providers should also inform the bereaved women about the biomedical causes of stillbirths that would be helpful to mitigate the stigma associated with stillbirths. Moreover, the health care providers should also counsel family members especially in-laws of these sorrowful women about the biomedical causes of stillbirths that would also be helpful to mitigate the stigma associated with stillbirths.

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“Getting it right when it goes wrong – Effective bereavement care requires training of the whole maternity team”

Cited by 6 publications

References 58 publications

Sexuality and affectivity after a grieving process for an antenatal death: a qualitative study of fathers' experiences

Sexuality and affectivity after a grieving process for an antenatal death: a qualitative study of fathers' experiences

Silent Tears of Midwives: ‘I Want Every Mother Who Gives Birth to Have Her Baby Alive’—A Narrative Inquiry of Midwives Experiences of Very Early Neonatal Death from Tanzania

The unspoken grief of multiple stillbirths in rural Pakistan: an interpretative phenomenological study

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