gms | German Medical Science

4th International Conference of the German Society of Midwifery Science (DGHWi)

Deutsche Gesellschaft für Hebammenwissenschaft e. V.

16.02.2018, Mainz

Midwifery care of follow-up pregnancies after losing a child

Meeting Abstract

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  • corresponding author Kerstin Pinnecke - Vinzenzhospital Hannover gGmbH, Hannover, Germany
  • Claudia Hellmers - University of Applied Sciences Osnabrueck, Faculty of Economics and Social Sciences, Osnabrueck, Germany

German Association of Midwifery Science. 4th International Meeting of the German Association of Midwifery Science (DGHWi). Mainz, 16.-16.02.2018. Düsseldorf: German Medical Science GMS Publishing House; 2018. Doc18dghwiP29

doi: 10.3205/18dghwi35, urn:nbn:de:0183-18dghwi353

This is the English version of the article.
The German version can be found at: http://www.egms.de/de/meetings/dghwi2018/18dghwi35.shtml

Published: February 13, 2018

© 2018 Pinnecke et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Text

Background: Families experiencing the pre-, peri- or postnatal death of a child are potential users of midwifery services. According to the German midwife salary regulation all women deserve the same midwifery care while and after a pregnancy even after a miscarriage or stillbirth or an abortion. Many orphaned parents experience a following pregnancy after the death of a child. Studies show that affected women experience their pregnancy with ambivalent feelings and usually distance themselves emotionally and cannot fully engage in the pregnancy [1]. Special offers such as self-help groups are described as great support [2]. Interactions with health care providers represented an important source of support for respondents.

Aim/research question: The evaluated literature mainly came from the USA, Canada and Australia. The questions how women in Germany experience a pregnancy after loss (PAL), which experiences they make with special offers and how they can improve their professional support, have not been researched yet. The aim was to determine the experience of a PAL from the point of view of those affected and to derive recommendations for midwifery care.

Methods: A collective of twelve affected women was interviewed in a qualitative survey. The recruitment took place through the association "Leere Wiege Hannover e.V.", which serves offers for orphaned parents. A method combination was used with a focus group with pregnant women and retrospective semi-structured interviews with mothers after a PAL. The data were analyzed using a qualitative content analysis according to Kuckartz [3].

Results: The results show a complex picture of the view of affected women. On the one hand the challenge of PAL is, that anxiety, ambivalent feelings and a delayed involvement in pregnancy arise due to the previously experienced loss and on the other hand those affected often do not have sufficient understanding and support in their social environment. The death of a child and the comprehensive impact on families still seems to be a tabood topic in society. The women want individualized care with the involvement of the partner and the deceased child.

Relevance: A professional family-centered care of the PAL as well as the creation of special offers are important to meet the needs of the women. In this context midwives can make a significant contribution. These results give a better understanding of the situation of affected women and families.

Recommendations/conclusion: Every midwife should reflect on her own work, do trainings and know her own professional limitations. She should pay attention to an empathetic and accurate anamnesis in order to identify individual needs of the women with the aim of a family-centered care. The affected persons should actively take part in decision making and the experiences with the lost child should be included in the professional conversation. Professional care should be characterized by understanding and empathy. It should offer security, involve the partner and, if possible, avoid reservations. In addition, interdisciplinary cooperation should be promoted and counseling for midwives should be provided.

Ethical criteria and conflict of interests: This research/project was approved by an ethics committee and is self-funded. There is no conflict of interest.

The PDF file of the poster submitted for the meeting is available in German as Attachment 1 [Attach. 1].


References

1.
Mills TA, Ricklesford C, Cooke A, Heazell, AEP, Whitworth M, Lavender T. Parents’ experiences and expectations of care in pregnancy after stillbirth or neonatal death: a metasynthesis. BJOG. 2014;121(8): 943-50.
2.
Côté-Arsenault D, Marshall R. One foot in – one foot out: weathering the storm of pregnancy after perinatal loss. Res Nurs Health. 2000;23(6): 473-85.
3.
Kuckartz U. Qualitative Inhaltsanalyse: Methoden, Praxis, Computerunterstützung. 1st ed. Weinheim: Beltz Juventa; 2012.