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父母对产前胎儿死亡时分娩的描述:来自悲伤分娩研究的结果。

Parents' descriptions of labouring with an antepartum fetal death: Findings from the Birthing in Grief study.

机构信息

UniSA Clinical and Health Sciences, UniSA, Adelaide, South Australia, Australia.

Evidence-Based Healthcare Research Division, JBI, Adelaide, South Australia, Australia.

出版信息

Aust N Z J Obstet Gynaecol. 2024 Apr;64(2):133-140. doi: 10.1111/ajo.13759. Epub 2023 Oct 13.

Abstract

BACKGROUND

Evidence to guide intrapartum care when an unborn baby has died is limited.

AIMS

To explore parents' experiences of care during labour of an antepartum stillbirth.

MATERIALS AND METHODS

Semi-structured interviews with 18 bereaved parents from across Australia. Content analysis was conducted.

FINDINGS

Two broad themes were identified: 'explaining every step' and 'helping us feel like parents.' Sub-themes under the first broad theme, 'explaining every step', were 'how and when information was given' and 'what happens next.' 'Like any other parent', 'feeling the pain' and 'everything is clouded' were sub-themes of the second broad theme. These findings mapped to current Australian clinical practice guidelines for bereavement care around stillbirth and neonatal death, ie good communication, recognition of parenthood, shared decision making and effective support.

CONCLUSIONS

This study on parents' experiences of labour with a fetal death in utero brings an important perspective to intrapartum care for this group. As far as we are aware, this study is the first to focus solely on this aspect of care. Our findings could be readily mapped to the four perinatal bereavement care goals. Parents wanted care providers to facilitate their choices, their sense of control, their autonomy and their agency. They wanted to feel that they had received the 'best' care available.

摘要

背景

指导胎儿死亡时分娩期护理的证据有限。

目的

探索父母在产前死胎分娩期间的护理体验。

材料与方法

对来自澳大利亚各地的 18 名丧亲父母进行半结构化访谈。进行了内容分析。

结果

确定了两个广泛的主题:“解释每一步”和“帮助我们感觉像父母一样”。“解释每一步”这一主题下的子主题为“信息的传递方式和时间”和“接下来会发生什么”。第二个主题“帮助我们感觉像父母一样”下的子主题为“像任何其他父母一样”、“感受痛苦”和“一切都变得模糊”。这些发现与澳大利亚现行的围产期胎儿死亡和新生儿死亡后丧亲护理临床实践指南相对应,即良好的沟通、承认父母身份、共同决策和有效的支持。

结论

这项关于胎儿宫内死亡时父母分娩体验的研究为这一群体的分娩期护理带来了一个重要视角。据我们所知,这项研究是首次专门关注这方面的护理。我们的研究结果可以很容易地映射到四个围产期丧亲护理目标上。父母希望护理提供者能够促进他们的选择、控制感、自主权和代理权。他们希望自己得到了“最好”的护理。

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