O'Connell O, Meaney S, O'Donoghue K
Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland; Cork University Maternity Hospital, Wilton, Cork, Ireland.
Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland; National Perinatal Epidemiology Centre, University College Cork, Cork, Ireland.
Midwifery. 2019 Apr;71:12-18. doi: 10.1016/j.midw.2018.12.016. Epub 2018 Dec 25.
As advances in prenatal diagnosis increasingly enable detection of life-limiting conditions, end-of-life care may start before birth. Termination of these pregnancies may have been default management, but in the Republic of Ireland, where termination is not a legal option, skilled experience in caring for mothers who continue their pregnancies has developed. This study examines the lived experience of four such mothers.
A qualitative study was designed using interpretive phenomenological analysis, which examined the maternal experience of continuing pregnancy with a prenatal diagnosis of anencephaly. Four mothers participated in semi-structured interviews on their experience of pregnancy and delivery of a baby with anencephaly.
A profoundly emotional journey represented an adaptive grieving process, which culminated in rich experiences of transformative growth for all the parents. The parents' relationship with their caregivers facilitated this process and the development of a meaningful parenting relationship with their babies. This positive finding coexists alongside a parallel experience of ongoing deep sense of loss and sadness.
Perinatal palliative care for those with a prenatal lethal diagnosis is a positive life experience for some mothers. The role of relationship with healthcare professionals is vital to the process and consideration must be given to a comprehensive multi-disciplinary team approach.
随着产前诊断技术的进步，越来越能够检测出危及生命的疾病，临终关怀可能在出生前就开始了。终止这些妊娠可能一直是默认的处理方式，但在爱尔兰共和国，终止妊娠不是一种合法选择，因此在照顾继续妊娠的母亲方面积累了丰富的经验。本研究考察了四位此类母亲的生活经历。
采用诠释现象学分析设计了一项定性研究，考察了产前诊断为无脑儿的情况下继续妊娠的母亲经历。四位母亲参与了关于她们怀有并分娩无脑儿的妊娠经历的半结构化访谈。
一段充满深刻情感的历程代表了一个适应性悲伤过程，最终所有父母都获得了丰富的转变性成长体验。父母与照顾者的关系促进了这一过程，以及他们与婴儿建立有意义的亲子关系。这一积极发现与持续存在的深深失落感和悲伤感并存。
对产前诊断为致命疾病者的围产期姑息治疗对一些母亲来说是一种积极的生活体验。与医疗保健专业人员的关系在这一过程中至关重要，必须考虑采用全面的多学科团队方法。
