Caelli Kate, Downie Jill, Letendre Angeline
Faculty of Nursing, University of Alberta, Edmonton, Canada.
J Adv Nurs. 2002 Jul;39(2):127-36. doi: 10.1046/j.1365-2648.2002.02252.x.
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.
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.
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.
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.
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.
本文报道了一项研究，该研究探讨了特殊分娩服务的影响。特殊分娩服务是一项由助产士管理的干预措施，作为常规护理的补充而开展，旨在为之前怀孕时婴儿死亡的高危孕妇及其伴侣提供支持和教育。
在美国，每年约有40,000个家庭遭受新生儿死亡的创伤*，而加拿大和澳大利亚的统计数据显示，相对于人口数量，情况类似。由于死产、流产和婴儿猝死综合征导致死亡的婴儿数量远多于这些统计数据所涵盖的，超过上述2%的育龄夫妇将面临失去婴儿的创伤。
这种情况可能对母亲健康造成的威胁在文献中已有广泛记载。然而，尽管最近关于围产期丧亲之痛影响的知识有所增长，但很少有干预措施专门为在失去婴儿后的孕期为澳大利亚和加拿大妇女及其伴侣提供支持而设计。
这项现象学研究探讨了妇女及其伴侣的悲伤和失落经历，以及通过特殊分娩服务项目为他们提供的支持。
面对澳大利亚和加拿大医疗保健系统的资金和组织变革，这些变革消除或减少了一些服务，本研究强化了对个性化、富有同情心的助产护理的需求，以及为这些妇女及其伴侣提供真正共情和支持性医疗服务的迫切需求。它还强调了需要让夫妇得到信息和支持，以使悲伤中的性别差异不会成为关系中的分裂因素。
这些发现对那些无法常规为这一弱势群体提供最佳护理的国家的护士和助产士的实践具有启示意义。该研究支持由助产士管理的护理模式，以确保妇女及其家庭在危机中得到适当支持。这些发现还深入了解了夫妇间多样的悲伤反应以及在失去婴儿后的孕期所经历的困难。
