Centre for Midwifery, Child and Family Health; University of Technology Sydney (UTS), Australia.
Centre for Midwifery, Child and Family Health; University of Technology Sydney (UTS), Australia.
Women Birth. 2022 Nov;35(6):e539-e548. doi: 10.1016/j.wombi.2022.01.009. Epub 2022 Feb 1.
The health of women is dependent on midwifery workforce stability. Retaining new midwives is paramount, however without support, the early career can be a vulnerable time for midwives.
Midwives care for women who experience poor perinatal outcomes like stillbirth and neonatal death. Midwifery care in these sentinel events is complex. There is limited understanding of early career midwives' experiences within these encounters.
To understand the experiences of Australian early career midwives' clinical encounters with perinatal grief, loss and trauma.
A qualitative descriptive/exploratory study using in-depth interviews.
Four themes were identified from interview data: (1) all eyes on the skills; (2) support is of the essence; (3) enduring an emotional toll; (4) at all times, the woman. Most participants had minimal exposure to perinatal loss as a student. As a result, most felt unskilled and unprepared for this as a new midwife.
Types and degrees of support varied in these encounters. Early career midwives who were well supported reflected positively on working with grief and loss. In contrast, inadequate or absent support had detrimental effects on participant wellbeing. Poorly supported encounters with death (intrapartum fetal, early neonatal, and maternal) in the early career period were significantly distressful, giving rise to mental and emotional distress.
Pre-registration perinatal loss skill development and supported experiences are necessary for preparedness. Continued education, formalised debriefing and mentoring, institutional philosophies which promote collegial ethics of care, and the expansion of continuity of midwifery care models will improve new midwives' experiences.
妇女的健康取决于助产士劳动力的稳定性。留住新助产士至关重要，然而，如果没有支持，助产士的早期职业生涯可能是一个脆弱的时期。
助产士照顾经历围产期不良结局（如死产和新生儿死亡）的妇女。在这些警戒事件中，助产护理很复杂。对于早期职业生涯中的助产士在这些遭遇中的经验，我们的了解有限。
了解澳大利亚早期职业生涯中的助产士在围产期悲伤、损失和创伤方面的临床遭遇经历。
采用深度访谈的定性描述/探索性研究。
从访谈数据中确定了四个主题：（1）关注技能；（2）支持至关重要；（3）承受情感负担；（4）始终关注女性。大多数参与者在学生时期很少接触围产期损失。因此，大多数人觉得自己在这方面没有技能和准备不足，作为一名新助产士。
这些遭遇中的支持类型和程度各不相同。得到良好支持的早期职业生涯中的助产士对处理悲伤和损失持积极态度。相比之下，支持不足或缺失对参与者的幸福感产生了不利影响。在早期职业生涯中，对死亡（产时胎儿、早期新生儿和产妇）的支持不足或缺失的遭遇非常痛苦，导致精神和情绪困扰。
注册前围产期损失技能发展和支持经验是必要的。继续教育、正式的汇报和指导、促进护理职业道德的机构理念以及扩大助产士连续护理模式将改善新助产士的体验。
