Portsmouth Hospitals NHS Trust, UK.
University of Surrey, UK.
Nurs Ethics. 2020 Jun;27(4):1103-1114. doi: 10.1177/0969733019874503. Epub 2019 Sep 16.
Midwives and nurses appear vulnerable to moral distress when caring for women whose babies are removed at birth. They may experience professional dissatisfaction and their relationships with women, families and colleagues may be compromised. The impact of moral distress may manifest as anger, guilt, frustration, anxiety and a desire to give up their profession. While there has been much attention exploring the concept of moral distress in midwifery, this is the first study to explore its association in this context.
This article explores midwives' experiences of moral distress when providing care to women whose babies were removed at birth and gives valuable insight into an issue nurses and midwives encounter in their profession.
Four mothers and eight midwives took part in this research. Narrative inquiry incorporating photo-elicitation techniques was used to generate data; mothers were interviewed face to face and midwives through focus groups. The images and audio data were collected, transcribed and analysed for emerging themes. For the purpose of this article, only the midwives' stories are reported. This research received a favourable ethical opinion from the University of Surrey Ethics committee.
This study received a favourable ethical approval from a higher education institutes ethics committee.
Midwives who care for women whose babies are removed at birth report it as one of the most distressing areas of contemporary clinical practice. Furthermore, they report feelings of guilt, helplessness and betrayal of the midwife-mother relationship. Many of the midwives in this study state that these experiences stay with them for a long time, far more than more joyful aspects of their role.
Midwives experience moral distress. Support systems, education and training must be available to them if we are to reduce the long-term impact upon them, alleviate their distress and prevent them from leaving the profession.
当照顾婴儿在出生时被带走的女性时，助产士和护士似乎容易感到道德困境。他们可能会感到职业不满，并且他们与女性、家庭和同事的关系可能会受到损害。道德困境的影响可能表现为愤怒、内疚、沮丧、焦虑和放弃职业的愿望。虽然已经有很多关注探索助产士在这方面的道德困境的概念，但这是第一项探索这种情况的关联的研究。
本文探讨了助产士在为出生时被带走婴儿的女性提供护理时的道德困境经历，并深入了解了护士和助产士在其职业中遇到的问题。
有四位母亲和八位助产士参与了这项研究。采用叙事研究结合照片引发技术来收集数据；对母亲进行面对面访谈，对助产士进行焦点小组访谈。收集图像和音频数据，进行主题分析。出于本文的目的，仅报告助产士的故事。这项研究得到了萨里大学伦理委员会的有利伦理意见。
这项研究得到了高等教育机构伦理委员会的有利伦理批准。
照顾婴儿被带走的女性的助产士报告说，这是当代临床实践中最痛苦的领域之一。此外，他们报告感到内疚、无助和背叛了助产士与母亲的关系。本研究中的许多助产士表示，这些经历会伴随他们很长时间，远远超过他们角色中更愉快的方面。
助产士经历道德困境。如果我们要减轻对他们的长期影响、减轻他们的困境并防止他们离开职业，他们必须获得支持系统、教育和培训。
