Impact of Perinatal Death on the Social and Family Context of the Parents
Abstract
:1. Introduction
2. Methods
2.1. Study Design
2.2. Participants
2.3. Data Collection
2.4. Data Analysis
2.5. Ethical Considerations
3. Results
3.1. Perinatal Death Affects Family Dynamics
“(…) Late at night our looks crossed, and he said: ‘Darling I’ve also been remembering’. And I: ‘Yes, I know you’ve been remembering’. But he doesn’t want to show that something is hurting”.(P-10)
3.1.1. The Father: The Struggle between Conserving the Stereotypical Protective Role and Succumbing to Pain
“I think that, even if it affects them… the feeling is different. You [the woman] have experienced it for a long time, that bond that you have created. As it wasn’t born, they have not felt it and it is different, you have felt it and the man only puts his hand there”.(P-14, Female)
“At least try to be the stronger, because I thought that, ‘Poof! How can I feel as down as she does…’ Maybe because I am the man (we have) to swallow it and stand on our feet or be a little stronger or (…) try to cry apart”.(P-4, Male)
“He tried to make himself strong, although occasionally I found him crying in the corner, where he thought I would not see him (…)”(P-16)
“In the ten years that I’ve been with him I’ve never seen him cry... he tried to become strong and brave, but he couldn’t, and he fell apart”.(P-14)
“But supposedly fathers have to be stronger than them. Stronger than them? Shit! That’s not true. We fathers have our feelings too, you know?”(P-7)
“Nobody cared about my husband. Because I was bad and he was more worried about me. So my husband couldn’t lean on anyone.”(P-19)
“She was given more attention, when it came to explaining things, when it came to telling things. Most of the time it was more towards her, (…) I was invisible to many people. However, I was also having a hard time.”(P-20)
3.1.2. The Elder Siblings: Feeling Overprotected or Abandoned
“We are more protective and spoil him a little more. For example, before he had to do a job to get something. But not now. Now he can always easily get something out of me…”(P-18)
“I already know what it is to lose a child, I have to take more care of them. My daughter tells me: ‘Why do you take so much care of me now?’, and I tell her I’m afraid that something could happen to her or someone could do something to her; it makes me very scared.”(P-10)
“My children told me, ‘Mommy, you’ve changed a lot, you’ve become indifferent to us, (...) I understand your pain and everything, but you’ve put us aside, you only cared about the little girl, and we need you’. And all that was true.”(P-2)
“… [My children] sometimes dared not talk to me because I didn’t feel like doing anything. I apologized to them because I turned away from them and became distant from them. I gave in so much to my pain, and this was the way of living my grief.”(P-12)
“He had a hard time telling our daughter. I remember being there, he told me that ‘Now how do I explain it to you, how can I tell you?’ But do you know what’s happened? that she hasn’t seen the baby (...) I haven’t shown her a photo. We chose not to say anything, why make her suffer?”(P-19)
“I didn’t say anything, because I thought she was strong, it was hard for me to tell my daughter things I’m not sure she’ll be able to understand. She asked me what was wrong with me and I told her that when I was older I would tell them.”(P-10)
“He always remembered and said: “Mom, and my little brother who is now in heaven? (crying) (...) and then he reminded me of him, and I tried not to cry, but I saw him so small that we both ended up crying.”(P-6)
“My son had a hard time. He got rather depressed. He still says his name today and makes drawings of his brother with (…), with his wings and such things.”(P-3)
“It affected him a lot, and he told his little brother, who was in my belly, that he was not going to love him like he had the other one. I think he didn’t want to become fond of him in case it happened again.”(P-5)
3.1.3. New Pregnancies Dominated by Fear: Medicalization and Avoidance
“… Even if they told you that everything is going well, every month each time I went to the ultrasound, well, imagine. I was outside [in the waiting room] and my legs were shaking.”(P-15)
“I went through the next three pregnancies in fear. A pain, [and I went] to the emergency room; a spot, to the emergency room (...). I went very often, I was very afraid. I was in panic in case I went through the same thing again.”(P-16)
“I would like to have a baby sometime, but I don’t want to go through the same thing again. I especially don’t want my wife to go through it again. I don’t know whether she could take it. So I avoid these thoughts.”(P-18)
“It may be positive for me to get pregnant again, but on the other hand I am very scared of going through that situation again. I don’t want to go through that situation again, it distresses me to think about it.”(P-19)
3.1.4. The Strengthening and Weakening of the Couple’s Bond
“We’ve talked a lot, and I’ve told him: ‘What has happened to us is something that we’ve been through together’. I have the feeling that it has brought us much closer.”(P-20, Male)
“We clung more to each other and became stronger. (...) We stuck together, [we think:] ‘do they want to hurt us? Well, nobody will be able to.’ Because I know this can break a marriage or a family.”(P-16, Female)
“We have more arguments than before, many more. Every time when I lose my temper because I am a little low or depressed or down, we argue.”(P-4, Male)
“... I have my own character, and we didn’t see it in the same way. And he shouted and said to me: Stop, don’t carry on! And interrupted me. (...) And I was enraged because I get angry when people shout at me.”(P-19, Female)
“Well... we were doing nothing for a while because I didn’t feel like it, how can you feel like it? You have your head somewhere else... when you’re sad, who is going to feel like it?”(P-1)
“At first I didn’t want to have sex, I didn’t feel like it, and I thought, what if I got pregnant? I didn’t feel like anything, I was afraid to go through it again, so I avoided sleeping with him.”(P-6)
3.2. The Social Environment of the Parents is Severely Affected After Perinatal Death
“We can’t do anything because there are babies everywhere, pregnant women everywhere… And we get depressed. So you don’t know where to go, and you lock yourself in the house.”(P-17)
3.2.1. Impact of the Perinatal Death on the Extended Family
“The family called us, and they worried about us, my sister, my aunt (pause) saw that she had hit rock bottom, and that’s why they called (...). I also imagine that they would be feeling bad. It was their nephew, and suddenly they don’t have him. They would call me and them (...) I know they had a bad time.”(P-7)
“I had never seen my mother (paternal grandmother) so bad, so bad (…).”(P-9)
“My mother lost a daughter and had no chance to grieve. She has grieved for her own daughter with her granddaughter. She had lost a daughter who had been stillborn thirty-five years before, and they didn’t want to teach her to grieve. They buried the baby immediately. So it’s been good for her, to mourn now.”(P-13)
3.2.2. Impact on Work: Lose a Child, Lose a Job
“It gave me bad depression, and I lost my job. I lost my job because they had to give me more days off, and they told me that they couldn’t wait any longer, and so I lost my job (...) everything combined, my baby died, and they fired me... It was one problem after another.”(P-2)
“I lost the habit of sleeping, I had to choose, let’s say I had to quit my job to be with my wife. (...) my wife wanted me to start... that I went to work, right? (...) I was going to work without sleep day after day and working, so think of it, working without sleep and with my head in another place.”(P-11)
“You are looking for your escape routes, either working (…) You isolate yourself a little from all of that because what you want is to avoid environments that remind you of your child.”(P-5)
3.2.3. Social Impact: Between Disenfranchised Grief and the Remembered Pain
“Then people tell you: ‘it’s better that it happened when the baby was three days old and not three months’, can you believe it? As if it hurt more before or after, you know? People are incredible.”(P-7)
“When I talk with friends, family, I try to make the effort, (…), to talk about my son and that I have been a father. Although nobody recognizes this, I am sure, I have felt responsible as a father, I have had the feeling of being a father.”(P-20)
“I don’t need anyone to validate my grief. But people frequently behave as if nothing had happened to you. People say that ‘as it was a baby you didn’t know... you know? You didn’t want it’ (pause) and I said: ‘Let’s see, didn’t you see my belly? (…) You can’t behave as if, as if nothing had happened.”(P-13)
“I was told: ‘Ah, don’t worry, in a year or two you will have another one’. ‘The same thing happened to my cousin, to my neighbor…’ I don’t care what happened to your cousin or your neighbor! I care about myself, and what has happened to me hurts.”(P-8)
“It makes you shut yourself up a little, that is, go out less, feel like being alone, withdraw a little (...). It has also isolated us from friends (...). My partner and I shut ourselves up at home more, inside ourselves.”(P-4)
“The horrible birthdays, (sob) but the worst thing is Christmas, when we get together with my nephews and nieces. (...). Because you see the children and say: ‘Oh no! Our baby could have been here’”(P-12)
“Wherever you go... you are reminded, and the child is not there, not there [silence]. It’s not there, and it’s frustrating (...). So we avoided being in places where there were children. It brought us the anxiety of remembering again... We had lost ours two months before”(P-5)
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Participant | Age | Sex | Nationality | Employment | Elder Children (Age Range) | Previous Loss (n) | Moment of Death | Age of Baby |
---|---|---|---|---|---|---|---|---|
P-1 | 26 | Female | Colombian | Employed | No | No | Intra-natal 1 | 40 weeks |
P-2 | 43 | Female | Colombian | Unemployed | Yes (8) | No | Ante-natal 2 | 30 weeks |
P-3 | 38 | Female | Spanish | Employed | Yes (8) | Yes (2) | Intra-natal | 24 weeks |
P-4 | 38 | Male | Spanish | Employed | No | Yes (2) | Intra-natal | 24 weeks |
P-5 | 37 | Female | Spanish | Employed | Yes (5) | No | Ante-natal | 34 weeks |
P-6 | 43 | Female | Spanish | Employed | Yes (6–12) | No | Post-natal 3 | 6 days |
P-7 | 43 | Male | Spanish | Employed | No | No | Post-natal | 6 days |
P-8 | 33 | Female | Spanish | Employed | No | No | Post-natal | 3 days |
P-9 | 33 | Male | Spanish | Employed | No | No | Post-natal | 3 days |
P-10 | 31 | Female | Ecuadorian | Unemployed | Yes (5) | Yes (1) | Ante-natal | 28 weeks |
P-11 | 26 | Male | Spanish | Employed | No | No | Ante-natal | 40 weeks |
P-12 | 30 | Female | Spanish | Unemployed | Yes (3) | No | Ante-natal | 40 weeks |
P-13 | 36 | Female | Spanish | Employed | No | No | Intra-natal | 24 weeks |
P-14 | 33 | Female | Spanish | Employed | No | No | Ante-natal | 36 weeks |
P-15 | 37 | Female | Spanish | Employed | No | Yes (1) | Ante-natal | 34 weeks |
P-16 | 37 | Female | Spanish | Unemployed | Yes (6–12) | No | Ante-natal | 38 weeks |
P-17 | 38 | Male | Spanish | Employed | Yes (6–12) | Yes (1) | Ante-natal | 38 weeks |
P-18 | 38 | Male | Spanish | Employed | Yes (7) | Yes (1) | Ante-natal | 37 weeks |
P-19 | 35 | Female | Spanish | Employed | Yes (7) | No | Ante-natal | 37 weeks |
P-20 | 35 | Male | Spanish | Employed | No | No | Ante-natal | 38 weeks |
P-21 | 37 | Male | Spanish | Employed | No | No | Ante-natal | 25 weeks |
Stage | Subject | Content/Example Questions |
---|---|---|
Introduction | Motives, reasons | Knowing their experiences to be able to help other parents in their situation. |
Ethical issues | Inform about volunteering, recording, consent, possibility of dropping out. | |
Beginning | Introductory question | Tell me your experience. What happened to you? |
Development | Conversation guide | How has your baby’s death affected your family? How has it affected your circle of friends? How has it affected your environment? |
Closing | Final question | Is there anything else you’d like to tell me? |
Appreciation | Thank them for taking part. Remind them of how their testimony will be used and tell them we are at their disposition. |
Quote | Initial Codes | Unit of Meaning | Subtheme | Theme |
---|---|---|---|---|
At the beginning he said, ‘No mommy, nothing’s going to happen, everything is going to work out well, we’re going to get over it, but... there came a time when he fell apart (P-2) | Father: encourage, Father: protect, Father: fall apart | Father: Role of protector | The father: struggle between conserving the stereotypical protective role and succumbing to the pain | Perinatal death shakes up the family dynamics |
I already know what it is to lose a child, I have to take care of them more. My daughter tells me: ‘Why do you take care of me so much now?’ I tell her that I’m scared something will happen to her or someone will do something to her. It scares me a lot (P-10) | Other children: take greater care of them. Other children: fear of something happening to them. Other children: notice over-protection | Siblings: over-protection | Elder siblings: between over-protection and abandonment |
Main Theme | Subtheme | Units of Meaning |
---|---|---|
Perinatal death affects family dynamics | The father: struggle between conserving the stereotypical protective role and succumbing to pain. | Masculine figure. Feelings. Father: lack of support. Father: traditional role. Father: protective role. Support. Father: forgetting. |
Elder siblings: feeling over-protected or abandoned | Siblings: overprotection. Abandonment of children. Affecting siblings. Siblings: concealment. Brothers: self-protection. Siblings: memories. Siblings: making a drawing. | |
New pregnancies dominated by fear: medicalization and avoidance | Fear of new pregnancy. Avoiding new pregnancy. Medicalization. New pregnancy. Fear. Panic. Repressing desires. | |
Between strengthening and weakening of the link between the couple. | Marriage. Increase in quarrels. Alteration of sexual relations. Strengthening of bond. | |
The social environment of the parents is severely affected after perinatal death | Impact of perinatal death on the extended family. | Affecting family. Grief of grandparents. Weeping. Solidarity. Seeing their own children suffering. |
Work impact: lose a child, lose a job. | Loss of job. Reduction of remuneration. | |
Social impact: between disallowing grief and remembering pain. | Unrecognized grief. Inappropriate social messages. Social isolation. Avoiding the presence of children. |
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Share and Cite
Fernández-Sola, C.; Camacho-Ávila, M.; Hernández-Padilla, J.M.; Fernández-Medina, I.M.; Jiménez-López, F.R.; Hernández-Sánchez, E.; Conesa-Ferrer, M.B.; Granero-Molina, J. Impact of Perinatal Death on the Social and Family Context of the Parents. Int. J. Environ. Res. Public Health 2020, 17, 3421. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17103421
Fernández-Sola C, Camacho-Ávila M, Hernández-Padilla JM, Fernández-Medina IM, Jiménez-López FR, Hernández-Sánchez E, Conesa-Ferrer MB, Granero-Molina J. Impact of Perinatal Death on the Social and Family Context of the Parents. International Journal of Environmental Research and Public Health. 2020; 17(10):3421. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17103421
Chicago/Turabian StyleFernández-Sola, Cayetano, Marcos Camacho-Ávila, José Manuel Hernández-Padilla, Isabel María Fernández-Medina, Francisca Rosa Jiménez-López, Encarnación Hernández-Sánchez, María Belén Conesa-Ferrer, and José Granero-Molina. 2020. "Impact of Perinatal Death on the Social and Family Context of the Parents" International Journal of Environmental Research and Public Health 17, no. 10: 3421. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17103421