The Experiences of Midwives Who Attend Births by Women with Life-Limiting Fetal Conditions (LLFC): A Phenomenological Research Study
Abstract
:1. Background
2. Materials and Methods
2.1. Study Design
2.2. Recruitment of Study Participants
2.3. Interviews and Data Analysis
3. Results
3.1. In Relation with the Woman Giving Birth
‘For me, the hardest part was to respond to their expectations, because somewhere deep inside I didn’t agree with them. I think that I would have acted differently in their place. But, at the same time I didn’t want to judge them and I wanted to help. So, in order to help them I had to get a feel for how they perceived the situation. And that was probably the hardest thing for me to do. To set aside what I felt in that situation and switch, in a moment, to their point of view’ (Interview no. 7).
What is probably the most difficult is the first meeting with this woman—when I have to sense what she needs, begin speaking, establish contact. And I don’t know what kind of mental state she is in, whether my questions about listening to her pulse, dressing the baby after birth, saying farewell, etc., will trigger a wave of tears or increase her pain. Whether she will go into a total block, in which I will have no contact with her. Seeking not to add to this woman’s suffering while, and at the same, finding out what her needs are so that I can meet them at least in some small way is very stressful. (Interview no. 12).
‘Listening to the heartbeat, following the progress of labor. I think that, yes, all this is difficult, especially for this woman. But also for me, because she most often takes any new information with anxiety in the 1st period, while in the 2nd period of labor it is the same. When she feels that the resolution is approaching, she tries to suppress it, as if to delay it, to postpone it in time’ (Interview no. 5).
‘It seems to us that the psychological pain is sufficient enough and we wish to relieve the physical pain [...]. But I think that we should still inquire about this, because some people are psychologically structured in such a way that they like to shift psychological pain onto physical pain and somehow this brings them relief, so I am not sure we should treat everyone in the same standard way’ (Interview no. 4).
3.2. In Relation with the Child and the Family
‘We also try to make sure that this baby suffers as little as possible during the course of the birth, so that visually it shows as little bruising and deformities as possible; so that later, after it has been born and wrapped in tetra cloth or a blanket [...], they can see this child [...] and so that this image, which will remain with them for the rest of their lives, causes as little trauma for them as possible’ (Interview no. 6).
- − to ensure that memories of childbirth are positive (Interview no. 3);
- − to make them feel secure (Interview no. 5);
- − to support them emotionally (Interview no. 6);
- − to spare them additional suffering (Interview no. 7).
‘they really wonderfully say goodbye to these children and I am full of admiration and very touched, and in part full or joy that we managed to have a wonderful birth in silence in such a marvelous atmosphere’ (Interview no. 13).
‘It seems to me that some couples come to the maternity ward and decide to give birth together without having given it much thought, and they must come to face with various things, while patients who come from the hospice have discussed many things with their partner, with a companion, or with a loved one’ (Interview no. 11).
3.3. In Relation with Oneself
‘Technically, the second stage of birth is really no different than in the case of a woman who gives birth to a healthy baby, because vertical positions are also used. Also, the patient can choose the position in which she is most comfortable’ (Interview no. 1).
‘I know what I can expect when meeting such a patient, any patient, actually. Because, in fact, whether that patient is giving birth to a sick baby, or a stillborn baby, or a normal baby, she pretty much requires the same thing. [...] one speaks one way with a patient who has a physiological pregnancy and a physiological birth, and differently to this [other] type of patient. It is obvious that you have to switch gears here. The worst thing is when one is conducting two births at once, that is, a physiological and a pathological one.’ (Interview no. 2).
‘I will sit down and think for a moment, […], for a minute or two. And I have to deal with the documentation because my shift will end in a moment, or else I have to go see a patient, because just because I assisted during a birth doesn’t mean that I can sit down for an hour, but I need to go see her, to check that she isn’t bleeding, and find out how she feels’ (Interview no. 2).
‘We spend the entire night in the birth room… it is a difficult experience to assist people in this situation... In her despair the mother even denied the humanity of her child and called on us to take “this” away from her…. Having carefully worked with their emotions all night, having overcome this anger, they said farewell to their child; they spend time with it and did everything they possibly could for the child. During the night, they came to terms with being parents to their stillborn child’ (Interview no. 15).
‘I was taught how to receive a birth from a woman who is expecting a healthy baby from the technical point of view, but I was not prepared to receive births from women who give birth to stillborn babies, or babies who will die in their arms. This isn’t easy, no one taught me how to deal with this, I need help to deal with these emotions’ (Interview no. 12).
3.4. In Relation with the Workplace
‘What I need, I think, is to be able to tell someone about it. And that brings relief. And I think, unfortunately I have to admit it, that it’s important that this person be a woman, and it’s wonderful if she is a midwife, that is, someone who walks in the same shoes as me’ (Interview no. 4).
‘I find it very helpful to talk to someone else, if it happens to be another midwife from the same shift, after work we go for an hour to sit in some quiet place to talk and I tell her about my emotions from the difficult shift’ (Interview no. 1).
‘I myself started going to such counseling. Some colleagues from various hospitals and I, five midwives in all, are going to such counseling with a psychologist once a month, so I suggested to the girls that we sit down sometimes, at least once in a while, to discuss our experiences and for each to tell what her approach was because I’m also learning different reactions, so to speak, from them’ (Interview no. 13).
4. Discussion
Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Person | Age | Personal Exp. of Maternity | Civil Status | Education | Specialization | Years in the Profession | Number of LFD Births | Hospital Location |
---|---|---|---|---|---|---|---|---|
1 | 50 | Yes | Married | BSc in midwifery | Ob-Gyn and Family | 16 | 10–15 | Warsaw |
2 | 36 | No | Married | MSc in midwifery | Ob-Gyn and Family | 26 | 10 | Warsaw |
3 | 40 | Yes | Married | MSc in midwifery | Ob-Gyn and Family | 19 | 10 | Warsaw |
4 | 53 | No | Married | MSc in obstetricsMSc in family nursing | Ob-Gyn | 27 | 10–15 | Warsaw |
5 | 44 | Yes | Married | MSc in midwifery | Family | 23 | 10 | Warsaw |
6 | 36 | Yes | Married | MSc in midwifery | Ob-Gyn | 14 | 10 | Warsaw |
7 | 30 | No | Married | MSc in midwifery | None | 7 | 5 | Warsaw |
8 | 50 | Yes | Married | BSc in midwifery | None | 34 | 20 | Opole |
9 | 54 | No | Married | BSc in midwifery | Ob-Gyn | 33 | 30 | Katowice |
10 | 62 | Yes | Married | MSc in midwifery | Ob-Gyn | 38 | 20 | Łódź |
11 | 37 | Yes | Married | MSc in midwifery | Ob-Gyn | 14 | 15 | Oleśnica |
12 | 52 | Yes | Married | MSc in midwifery | Ob-Gyn | 31 | 10–15 | Gdańsk |
13 | 53 | Yes | Single | BSc in midwifery | Neonat-Epid | 32 | 15–20 | Wrocław |
14 | 41 | Yes | Single | BSc in midwifery | None | 20 | 10 | Wrocław |
15 | 50 | Yes | Married | MSc in midwiferyMA in education | Family | 24 | 5–10 | Warsaw |
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Tataj-Puzyna, U.; Heland-Kurzak, K.; Sys, D.; Szlendak, B.; Ryś, M.; Krauze, M.; Baranowska, B. The Experiences of Midwives Who Attend Births by Women with Life-Limiting Fetal Conditions (LLFC): A Phenomenological Research Study. Healthcare 2023, 11, 1540. https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare11111540
Tataj-Puzyna U, Heland-Kurzak K, Sys D, Szlendak B, Ryś M, Krauze M, Baranowska B. The Experiences of Midwives Who Attend Births by Women with Life-Limiting Fetal Conditions (LLFC): A Phenomenological Research Study. Healthcare. 2023; 11(11):1540. https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare11111540
Chicago/Turabian StyleTataj-Puzyna, Urszula, Krystyna Heland-Kurzak, Dorota Sys, Beata Szlendak, Maria Ryś, Magdalena Krauze, and Barbara Baranowska. 2023. "The Experiences of Midwives Who Attend Births by Women with Life-Limiting Fetal Conditions (LLFC): A Phenomenological Research Study" Healthcare 11, no. 11: 1540. https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare11111540