Ryninks Kirsty, Roberts-Collins Cara, McKenzie-McHarg Kirstie, Horsch Antje
Department of Child and Adolescent Psychiatry, Research Unit, University Hospital Lausanne, Rue du Bugnon 25 A, Lausanne CH-1011 Lausanne, Switzerland.
BMC Pregnancy Childbirth. 2014 Jun 13;14:203. doi: 10.1186/1471-2393-14-203.
Guidelines surrounding maternal contact with the stillborn infant have been contradictory over the past thirty years. Most studies have reported that seeing and holding the stillborn baby is associated with fewer anxiety and depressive symptoms among mothers of stillborn babies than not doing so. In contrast, others studies suggest that contact with the stillborn infant can lead to poorer maternal mental health outcomes. There is a lack of research focusing on the maternal experience of this contact. The present study aimed to investigate how mothers describe their experience of spending time with their stillborn baby and how they felt retrospectively about the decision they made to see and hold their baby or not.
In depth interviews were conducted with twenty-one mothers three months after stillbirth. All mothers had decided to see and the majority to hold their baby. Qualitative analysis of the interview data was performed using Interpretive Phenomenological Analysis.
Six superordinate themes were identified: Characteristics of Contact, Physicality; Emotional Experience; Surreal Experience; Finality; and Decision. Having contact with their stillborn infant provided mothers with time to process what had happened, to build memories, and to 'say goodbye', often sharing the experience with partners and other family members. The majority of mothers felt satisfied with their decision to spend time with their stillborn baby. Several mothers talked about their fear of seeing a damaged or dead body. Some mothers experienced strong disbelief and dissociation during the contact.
Results indicate that preparation before contact with the baby, professional support during the contact, and professional follow-up are crucial in order to prevent the development of maternal mental health problems. Fears of seeing a damaged or dead body should be sensitively explored and ways of coping discussed. Even in cases where mothers experienced intense distress during the contact with their stillborn baby, they still described that having had this contact was important and that they had taken the right decision. This indicates a need for giving parents an informed choice by engaging in discussions about the possible benefits and risks of seeing their stillborn baby.
在过去三十年里,关于母亲与死产婴儿接触的指导方针一直相互矛盾。大多数研究报告称,与未接触死产婴儿的母亲相比,见到并抱过死产婴儿的母亲焦虑和抑郁症状更少。相比之下,其他研究表明,与死产婴儿接触可能导致母亲心理健康状况更差。目前缺乏针对母亲这种接触体验的研究。本研究旨在调查母亲们如何描述与死产婴儿相处的经历,以及她们对自己决定是否见到并抱过婴儿的事后感受。
在死产后三个月,对21位母亲进行了深入访谈。所有母亲都决定见到婴儿,大多数母亲还决定抱过婴儿。使用解释现象学分析法对访谈数据进行了定性分析。
确定了六个上位主题:接触的特点、身体感受;情感体验;超现实体验;终结感;以及决定。与死产婴儿接触让母亲们有时间梳理所发生的事情、建立记忆并“道别”,她们通常会与伴侣和其他家庭成员分享这段经历。大多数母亲对自己决定与死产婴儿相处感到满意。几位母亲谈到了她们对看到受损或死亡身体的恐惧。一些母亲在接触过程中经历了强烈的怀疑和分离感。
结果表明,在与婴儿接触前做好准备、接触期间提供专业支持以及专业随访对于预防母亲心理健康问题的发展至关重要。应敏感地探讨对看到受损或死亡身体的恐惧,并讨论应对方法。即使在母亲们与死产婴儿接触期间经历了强烈痛苦的情况下,她们仍然表示这种接触很重要,且自己做出了正确的决定。这表明需要通过讨论见到死产婴儿可能的益处和风险,让父母做出明智的选择。