Investigation of the Experiences of Mothers Living Through Prenatal Loss Incidents: A Qualitative Study

Termination of pregnancy due to fetal anomaly: A qualitative study from Turkey on women's experiences

BACKGROUND

Termination of pregnancy due to fetal anomaly is an unexpected traumatic event for women. It can cause serious complications that can negatively affect both the physical and psychological health of women.

AIM

This study aims to examine the experiences of women who underwent medical termination for fetal anomaly in the second trimester.

METHODS

The study included 12 women whose pregnancies were terminated due to fetal anomaly. Data were collected through in-depth interviews until data sufficiency was reached. Thematic analysis method was used to analyze the data. This study was conducted using an inductive qualitative design. The women's statements were examined and double-coded. By examining the codes, main themes were created after sub-themes.

RESULTS

Women's experiences were analyzed in five themes: difficulty in decision-making (1), emotional impact (2), stigmatization (3), dilemma between hope and anxiety (4), and post-termination care and support needs (5). Participants stated that they experienced many emotions such as indecision, sadness, helplessness, guilt, and remorse during the medical termination process. Hope, anxiety, fear, social pressure and support needs were also frequently experienced in this process.

CONCLUSION

Termination of pregnancy in the second trimester due to fetal anomaly caused significant psychological symptoms. In order to prevent long-term health complications, it will be important for health professionals to provide interventions designed to meet the demands of women diagnosed with fetal anomaly.

"The Dark Farewell to the Light of Life": A Qualitative Study About Prenatal Loss

AIM

This study was conducted to determine the experiences of women who encountered loss in the prenatal period.

METHOD

This study was a qualitative study conducted using the phenomenological method and was conducted according to the guidelines of the COREQ checklist. A total of 11 women who were experienced loss in the early prenatal period were interviewed. The data were analyzed using the content analysis.

RESULTS

Three main themes and eight sub-themes emerged. The themes were light of life (bubble of happiness, journey), dark farewell (silent scream inside, unfinished tale: motherhood, loneliness, family approach) and obscurity (uncertainty about the future, need for support). Women expressed that the loss process had negative effects on their mental health and that they needed help.

CONCLUSION

Pregnancy illuminates women's lives, while prenatal loss involves intense and various negative emotions, and women need support in many ways. These results show that women who experienced loss in the prenatal period should be allowed to express their feelings, thoughts and experiences, and the risks in terms of mental health should be reduced by supporting them during the loss and mourning process.

Navigating miscarriage in Jordan: understanding emotional responses and coping strategies

BACKGROUND

Miscarriages account for 20% of clinically confirmed pregnancies and up to 50% of all pregnancies and is considered one of the most heartbreaking events experienced by women. The current study aimed to explore participants' perceptions and practices and how they link with the negative emotions of miscarriage.

METHODS

In this cross-sectional study a web-based questionnaire was used to gather data from 355 women living in Jordan who had experienced a previous miscarriage. The questionnaire consisted of four sections, including socio-demographic information, experience with miscarriage, emotions after the experience, and self-care practices. Participants were recruited through social media platforms from April to August 2022. Data were analyzed using SPSS, and descriptive statistics, chi-square test, and binomial regression were performed to examine the results.

RESULTS

The results show that the majority of participants were in the age group of 22-34 years and a larger percentage of participants hold a Bachelor's degree and were employed. All participants had experienced a previous miscarriage with 53.8% having one, 27.0% having two, and 19.2% having three or more miscarriages. In addition, most miscarriages did not have an explanation for their cause (77.5%), but vaginal bleeding was the most reported symptom (55.2%) and surgical management was predominant (48.7%). Most participants reported adequate emotional support from partners and family (63.7% and 62.3%, respectively). Almost half (48.7%) of the respondents felt like they had lost a child and those who did not receive any social support had a higher association with the same feeling (p = 0.005). Of the participating women, 40.3% decided to postpone another pregnancy while 20.0% planned for a subsequent pregnancy. The feeling of shame regarding the miscarriage was the main driver for women to get pregnant again (Odd ration [OR] 2.98; 95% confidence interval (CI) 1.31-6.82; p = 0.01).

CONCLUSIONS

The findings highlight the emotional impact of miscarriage on women and the need for proper support and self-care practices.

The needs of women experiencing perinatal loss: A qualitative systematic review and meta-synthesis

PROBLEM

There have been some studies on the needs of women experiencing perinatal loss in various socio-cultural contexts, but there is no research that systematically and comprehensively synthesizes these needs.

BACKGROUND

Perinatal loss has profound psychosocial effects. The misconceptions and prejudices existing in the public, the lack of satisfactory clinical care, and the available social support may all increase the negative impact.

AIM

To synthesize evidence for the needs of women experiencing perinatal loss, attempt to explain the findings, and provide insights into the application of evidence.

METHODS

Published papers were searched in seven electronic databases until 26 March 2022. The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research was used to assess the methodological quality of the included studies. Through meta-aggregation, the data was extracted, rated, and synthesized, resulting in new categories and findings. The credibility and dependability of the synthesized evidence were evaluated by ConQual.

FINDINGS

Thirteen studies that fulfilled the inclusion criteria and quality assessment were included in the meta-synthesis. Five synthesized findings were identified, covering information needs, emotional needs, social needs, clinical care needs, as well as spiritual and religious needs.

CONCLUSION

Women's perinatal bereavement needs were individualized and diverse. There is a necessity to understand, identify, and respond to their needs in a sensitive and personalized way. Families, communities, healthcare institutions, and society form a coordinated whole and provide accessible resources to improve recovery from perinatal loss and a satisfactory outcome in the subsequent pregnancy.

Loneliness in pregnant and postpartum people and parents of children aged 5 years or younger: a scoping review

BACKGROUND

Despite evidence that loneliness increases during times of transition, and that the incidence of loneliness is highest in young adults, loneliness during pregnancy and new parenthood has not been developed as a program of research. Because loneliness research has primarily focused on older adults and other high-risk populations, the concept of loneliness and its effects on this population are not well understood, leaving a gap in our understanding of the psychosocial needs and health risks of loneliness on pregnant people and new parents. A scoping review has been completed in order to map and synthesize the literature on loneliness experienced during pregnancy and the first 5 years of parenthood prior to the COVID-19 pandemic.

METHODS

To address the aim of this review, a wide net was cast in order to detect experiences of perinatal or parental loneliness and/or instances where loneliness was measured in this population. Among the inclusion criteria were loneliness in people who were pregnant, who were parents in the postpartum period, or who had children aged 5 years or younger. A search for literature was conducted in December 2020 using nine databases: MEDLINE (Ovid), EMBASE (Elsevier), SCOPUS (Elsevier), Cochrane Library including CENTRAL (Wiley), CINAHL (Ebscohost), PsycINFO (Ebscohost), Dissertations & Theses Global (ProQuest) and Sociological Abstracts (ProQuest), and the Web of Science Core Collection (Clarivate).

RESULTS

Perinatal and parental loneliness studies are limited and have rarely been targeted and developed through a program of research. Loneliness inquiry in this population was frequently studied in relation to other concepts of interest (e.g., postpartum depression). Alternatively, the importance of loneliness emerged from study participants as relevant to the research topic during qualitative inquiry. Across studies, the prevalence of loneliness ranged from 32 to 100%. Loneliness was commonly experienced alongside parenting difficulties, with parents feeling as though they were alone in their struggles.

CONCLUSIONS

As loneliness has been called a sensitive indicator of mental wellbeing, we believe screening will help healthcare professionals identify common difficulties and early signs of depression experienced during pregnancy and parenthood.

SYSTEMATIC REVIEW REGISTRATION

The protocol is available on Open Science Framework at DOI 10.17605/OSF.IO/BFVPZ.

Clinical practice guidelines for perinatal bereavement care: A systematic quality appraisal using AGREE II instrument

PURPOSE

This study aimed to evaluate and analyze the methodological quality of the published clinical practice guidelines (CPGs) for perinatal bereavement care and provide a reference for implementing best clinical practices.

METHODS

We performed a systematic and comprehensive search in five electronic databases (PubMed, The Cochrane Library, Web of Science, CNKI, Wan Fang Database), eight guideline databases, and six websites of professional organizations from March 2021 to June 2021. Four researchers used the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument to appraise the selected CPGs independently. The inter-rater reliability of AGREE II domains was calculated using the intraclass correlation coefficient with 95% CI.

RESULTS

We included a total of 8 CPGs. The mean scores of six domains ranged from the lowest score of 46.61% (editorial independence) to the highest score of 87.85% (clarity of presentation). Subgroup analysis showed no statistical difference. Each domain achieved "good" and "very good" intraclass reliability. Two CPGs were deemed as grade A (strongly recommended), five were rated as grade B (recommended with modifications), and one was evaluated as grade C (not recommended).

CONCLUSIONS

Healthcare professionals in obstetrics and neonatology play an important role in helping bereaved parents and families to cope with perinatal loss. High-quality CPGs for perinatal bereavement care can serve as useful resources to improve the quality and outcomes of clinical practice. More efforts should be made to disseminate the best practices for perinatal bereavement care. When implementing GCPs in countries or regions with different backgrounds, professional translations, strict validations, and cultural adaptations should be taken into account.

Role of COVID-19 pandemic in the academic life and well-being of private sector university students: an exploratory qualitative study

OBJECTIVE

The advent of the COVID-19 pandemic has caused a drastic impact on students' life, causing physical and emotional sufferings. Considering the relevance of unprecedented conditions, we explored perceptions and attitudes of students towards their academic life and well-being amid the COVID-19 pandemic.

SETTING

We conducted an exploratory qualitative study using a purposive sampling approach conducted at a single-centre private nursing institution in Karachi, Pakistan.

PARTICIPANTS

The current study used in-depth interviews with female university students. Study data were analysed manually using the thematic analysis approach.

PRIMARY OUTCOME

The primary outcome is to explore perception of students on academic life and well-being amidst the COVID-19 pandemic.

RESULTS

A total of 10 in-depth interviews were conducted between August and September 2020. Four overarching themes were identified: (1) impact of COVID-19 on students' well-being; (2) effect of COVID-19 on students' academic life; (3) current coping mechanisms adopted by students and (4) recommendations to address students' concerns. The pandemic-related stressors served as a major impediment on students' motivation, concentration span and socioeconomic conditions which negatively influenced their well-being and academic life. However, students have adopted diverse coping mechanisms to combat unstable circumstances that include connecting with family and relatives, indulging in diverse activities, and getting academic support from faculty, senior students, and university administration. Students also recommended the need for arranging online mental health services, integrating e-learning mediums in existing academia, and constant efforts by the government to address electricity and internet connectivity issues to promote virtual learning.

CONCLUSION

University students have been struck hard due to rapid pandemic-related transitions in their life. The study finding served as the potential guide for educational institutions and government officials to employ appropriate psychological interventions and provide infrastructure and technical facilities to provide support with their academic journey and overcoming the ongoing pandemic repercussions.

Early pregnancy loss: Invisible but real

ABSTRACT

One of every five pregnancies ends in miscarriage, disputing the common misconception that miscarriage is rare. Early pregnancy loss has a complex impact on women's mental health, requiring compassionate, trauma-informed care. This article explores the emotional and psychological impacts of miscarriage, and strategies for nurses to support the needs of patients after a miscarriage.

Impact of living with a bilateral central vision loss due to geographic atrophy-qualitative study

OBJECTIVE

Geographic atrophy (GA), a type of dry age-related macular degeneration, affects vision as central vision loss (CVL). The challenges faced due to bilateral CVL in activities of daily living and strategies taken to overcome those challenges are not very well understood in the Indian population. This qualitative study aims to understand the impact on everyday life activities and related adaptive and coping strategies in people with long-standing bilateral CVL due to GA in India.

DESIGN, PARTICIPANTS, SETTING AND METHODS

A qualitative study using a semistructured face-to-face interview was conducted on 10 people with bilateral CVL after obtaining written informed consent. The interviews were audio-recorded, and were transcribed verbatim. Thematic analysis was carried out to understand the challenges faced and adaptive methods due to the impact of CVL.

RESULTS

Ten participants (50% male) with a median age (IQR) of 72 (70, 74) years were interviewed. All the participants had best-corrected visual acuity of ≤6/60 in the better eye and reported an absolute central scotoma with the home Amsler chart. Qualitative thematic analysis identified four main themes: challenges in everyday living (difficulty in face identification, reading), challenges with lifestyle and socialisation (driving, cooking, reading for a longer duration, watching TV, socially inactive), psychological implications (depression, poor self-esteem, fear due to poor vision) and strategies to overcome the challenges (voice identification, technology support).

CONCLUSION

GA has a severe negative impact on the quality of life in people with CVL. Inability to recognise faces was the main reason for dependency on others and being socially disconnected. The findings will help clinicians in providing improved rehabilitative care.

Nursing Interventions to Facilitate the Grieving Process after Perinatal Death: A Systematic Review

Perinatal death is the death of a baby that occurs between the 22nd week of pregnancy (or when the baby weighs more than 500 g) and 7 days after birth. After perinatal death, parents experience the process of perinatal grief. Midwives and nurses can develop interventions to improve the perinatal grief process. The aim of this review was to determine the efficacy of nursing interventions to facilitate the process of grief as a result of perinatal death. A systematic review of the literature was carried out. Studies that met the selection criteria underwent a quality assessment using the Joanna Briggs Institute critical appraisal tool. Four articles were selected out of the 640 found. Two are quasi-experimental studies, and two are randomized controlled clinical studies. The interventions that were analyzed positively improve psychological self-concept and role functions, as well as mutual commitment, depression, post-traumatic stress and symptoms of grief. These interventions are effective if they are carried out both before perinatal loss and after it has occurred. The support of health professionals for affected parents, their participation in the loss, expressing feelings and emotions, using distraction methods, group sessions, social support, physical activity, and family education are some of the effective interventions.