Both empowered and powerless: mothers' experiences of professional care when their newborn dies.

BACKGROUND

The death of a newborn is a complex and tragic situation, the uncertain and stressful nature of which places emotional burdens on the parents. The aim of this study was to examine and illuminate mothers' experiences and perceptions of the care given to them at neonatal clinics while facing the threat and the reality of losing their baby.

METHOD

Interviews were performed, in the form of conversations, with 16 mothers approximately 2 years after the death of their newborns. The interviews were analyzed using a hermeneutic phenomenological method.

RESULTS

The primary themes identified were feeling empowered and feeling powerless. Three related themes to feeling empowered were a sense of nearness--supporting confidence; a sense of encouragement--supporting self-esteem; and a sense of empathy--supporting comfort. Three related themes to feeling powerless were a sense of distance--leading to strength or adjustment; a sense of violation--leading to helplessness and despondency; and a sense of disconnection--leading to insecurity and discouragement. All mothers felt both empowered and powerless. When experiencing empowering care, they had a feeling of encountering benevolence, with respect to their individual desires. Experiencing competent care without humane treatment madethemfeel powerless, and they were neither respected as a mother nor a person.

CONCLUSIONS

Feelings of empowerment emerged when the health care professionals not only saw the mother as an individual but also "saw through the mothers' eyes" and "felt with the mother's feelings". Feelings of powerlessness emerged when the similarity in the lifeworld (i.e., the world of lived experiences) differed, and the perspectives of the mothers and the health care professionals did not correspond.