Pregnancy Loss Research Group, The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork University Maternity Hospital, 5th floor, Wilton, Cork, Ireland; National Perinatal Epidemiology Centre (NPEC), University College Cork, Cork University Maternity Hospital, 5th floor, Wilton, Cork, Ireland; Cork University Maternity Hospital, Wilton, Cork, Ireland.
Pregnancy Loss Research Group, The Irish Centre for Maternal and Child Health Research (INFANT), University College Cork, Cork University Maternity Hospital, 5th floor, Wilton, Cork, Ireland; Cork University Maternity Hospital, Wilton, Cork, Ireland.
Midwifery. 2020 Dec;91:102841. doi: 10.1016/j.midw.2020.102841. Epub 2020 Sep 10.
Pregnancy loss and the death of their baby can be overwhelming for families, especially when the loss is unexpected. The standard of bereavement care families receive around the time of pregnancy or early infant loss can have a significant impact on their psychological recovery. At times external inquiries are carried out to identify issues in the maternity care provided and make recommendations to improve its' standard.
This study aims to describe the impact of bereavement care provided to families around the time of pregnancy and/or early infant loss as stated in ten published inquiry reports related to Irish maternity services.
Using thematic analysis, issues with care encountered by bereaved parents as outlined in the reports were identified. These focussed around five main themes (communication, healthcare staff skills, maternity unit environment, post-mortem/coronial process, local incident reviews).
Bereavement care, as described by families in the ten reports, was not consistently individualised or respectful, resulting in additional feelings of anger and upset. Problems with clear communication of complex issues, in a manner that is understandable to bereaved families, were identified in several reports. Recommendations from the inquiry reports included that experienced and skilled staff should always be available to provide immediate support to bereaved families as appropriate, and assist families in understanding and processing information around the time of their loss.
Consistent, individualised bereavement care facilitates a seamless transition for bereaved families from diagnosis through the hospital stay to discharge and follow-up, allowing them to focus on their baby, their bereavement and their family's wellbeing. The process of consent for a perinatal post-mortem and associated concerns have evolved over the timeframe of the ten inquiries. We reflect further on this and the impacts of the other issues highlighted, as well as discussing possible improvements to address them as described in the scientific literature.
妊娠丢失和婴儿夭折会给家庭带来沉重的打击，尤其是当这种损失是意外发生的时候。家庭在妊娠或婴儿早期丢失时所接受的丧亲关怀标准会对他们的心理康复产生重大影响。有时会进行外部调查，以确定提供的产妇保健服务中存在的问题，并提出改进标准的建议。
本研究旨在描述在与爱尔兰产科服务相关的十份已发表调查报告中，所阐述的在妊娠和/或婴儿早期丢失时向家庭提供的丧亲关怀的影响。
使用主题分析，确定报告中概述的丧亲父母遇到的护理问题。这些问题主要集中在五个主题上（沟通、医护人员技能、产科病房环境、尸检/验尸程序、当地事件审查）。
在十份报告中，家庭所描述的丧亲关怀并非始终是个性化或尊重的，导致他们产生更多的愤怒和不安情绪。几份报告中都指出了在以丧亲家庭能够理解的方式清晰沟通复杂问题方面存在问题。调查报告中的建议包括，应始终有经验丰富和熟练的工作人员在适当的时候向丧亲家庭提供即时支持，并协助他们理解和处理失去婴儿时的信息。
一致的、个性化的丧亲关怀有助于丧亲家庭从诊断到住院到出院和随访的无缝过渡，使他们能够专注于他们的婴儿、他们的丧亲之痛和他们家庭的幸福。在十次调查的时间范围内，对围产期尸检的同意过程及其相关问题进行了进一步的反思。我们进一步反思了这一点，以及其他突出问题的影响，并讨论了根据科学文献描述的可能的改进措施。
