University of California, Irvine Department of Obstetrics and Gynecology, Orange, CA, United States.
University of California, Irvine Department of Obstetrics and Gynecology, Orange, CA, United States; University of California, Irvine Sue & Bill Gross School of Nursing, Irvine, CA, United States.
Contraception. 2021 Sep;104(3):301-304. doi: 10.1016/j.contraception.2021.04.014. Epub 2021 Apr 22.
This study sought to explore labor and delivery (L&D) nurses' experiences caring for women undergoing induction for intrauterine fetal demise (IUFD) or termination for fetal anomalies, and to characterize reluctance towards participation in abortion care or - conversely - the commitment to provide services.
Researchers conducted a qualitative study that consisted of open-ended, semistructured interviews with 15 registered nurses who care for women on L&D at a large metropolitan hospital. We analyzed these data for content and themes.
Labor and delivery nurses struggle emotionally, logistically, and morally with bereavement care, whether their patients are experiencing an IUFD or termination for fetal anomalies. The analysis generated the following themes: the emotionally intense work of perinatal loss, feelings of incompetence in bereavement care, ethical conflicts, and judgment of both termination and IUFD patients. In addition, nurses who chose to provide care for patients undergoing induction termination for fetal anomalies described a duty to care for all patients despite the increased logistic and emotional burden.
Much of the discomfort L&D nurses reported caring for patients undergoing induction termination stems from the emotional toll, lack of skills, and bureaucratic burden of bereavement care rather than a moral objection to abortion. Instituting interventions to improve staffing, simplify paperwork, augment bereavement training, and improve support for the emotional burden of caring for these patients may therefore increase access to competent and compassionate abortion care.
Labor and delivery nurses struggle with bereavement care whether their patients are experiencing an IUFD or termination for fetal anomalies. Instituting interventions - like interdisciplinary simulation - to support nurses in bereavement care may increase the number willing to participate in abortion care, thereby improving patient access.
本研究旨在探讨为因宫内胎儿死亡（IUFD）或因胎儿畸形而终止妊娠的妇女提供引产服务的产科护士的经历，并描述她们对参与堕胎护理的不情愿或相反的提供服务的承诺。
研究人员进行了一项定性研究，对在一家大型大都市医院的产科病房照顾妇女的 15 名注册护士进行了开放式、半结构式访谈。我们对这些数据进行了内容和主题分析。
产科护士在处理围产期丧失的过程中在情感、后勤和道德方面都感到挣扎，无论他们的患者是经历 IUFD 还是因胎儿畸形而终止妊娠。分析产生了以下主题：围产期丧失带来的强烈情感工作、在丧亲护理方面的不称职感、伦理冲突以及对终止妊娠和 IUFD 患者的判断。此外，选择为因胎儿畸形而接受引产终止妊娠的患者提供护理的护士描述了一种照顾所有患者的责任，尽管这增加了后勤和情感负担。
产科护士在为接受引产终止妊娠的患者提供护理时所报告的大部分不适，源于丧亲护理的情感代价、缺乏技能和官僚主义负担，而不是对堕胎的道德反对。因此，实施干预措施以改善人员配备、简化文书工作、增加丧亲培训，并为照顾这些患者的情感负担提供支持，可能会增加获得有能力和富有同情心的堕胎护理的机会。
产科护士在其患者经历 IUFD 或因胎儿畸形而终止妊娠时都在处理丧亲护理方面存在困难。实施干预措施，如跨学科模拟，以支持护士在丧亲护理方面的工作，可能会增加愿意参与堕胎护理的人数，从而改善患者的获得途径。
