Parents' experiences of midwife-managed care following the loss of a baby in a previous pregnancy
Article first published online: 27 JUN 2002
Journal of Advanced Nursing
Volume 39, Issue 2, pages 127–136, July 2002
How to Cite
Caelli, K., Downie, J. and Letendre, A. (2002), Parents' experiences of midwife-managed care following the loss of a baby in a previous pregnancy. Journal of Advanced Nursing, 39: 127–136. doi: 10.1046/j.1365-2648.2002.02252.x
- Issue published online: 27 JUN 2002
- Article first published online: 27 JUN 2002
- Submitted for publication 20 August 2001 Accepted for publication 9 April 2002
- perinatal loss;
- health promotion
Aims of the study. This article reports on research that explored the impact of the Special Delivery Service, a midwife-managed intervention, developed as an addition to routine care to support and educate high-risk pregnant women and their partners subsequent to the death of a baby in a previous pregnancy.
Background. Approximately 40 000 families suffer the trauma of a neonatal death * annually in the USA, while statistics for Canada and Australia give similar numbers relative to population. Since many more babies die than those accounted for in these statistics, through stillbirth, miscarriage and Sudden Infant Death Syndrome, more than the above-cited 2% of childbearing couples will face the trauma of the loss of a baby.
Rationale. The resultant threat that this situation may pose to the health of the mother has been extensively documented in the literature. However, despite the recent growth in knowledge about the impact of perinatal loss and bereavement, few interventions are specifically designed to support Australian and Canadian women and their partners during a pregnancy following the loss of a baby.
Methodology. This phenomenological study explored women's and their partners' experiences of grief and loss and the support offered to them through the Special Delivery Service programme.
Results & Discussion. In the face of funding and organizational changes to both the Australian and Canadian health care systems that have eliminated or reduced some services, this research reinforced the need for individualized, compassionate midwifery care and the urgent need for genuinely empathic and supportive health care services for these women and their partners. It also emphasized the need for couples to be informed and supported so that gender differences in grieving do not become a divisive element in the relationship.
Conclusions. The findings have implications for both nurses and midwives in their practice in countries where optimum care of this vulnerable population is not routinely available. The research supports midwife-managed models of care to ensure women and their families are appropriately supported in crisis. The findings provide insight also into the diverse grief response among couples and the difficulties experienced in a pregnancy following the loss of a baby.