Cates Frances, Wetzler Sara, Wishlade Tabitha, Patel Mehali, Aiken Catherine E
Department of Liberal Arts (Cates), University of Texas at Austin, Austin, Texas.
Department of History and Philosophy of Science (Wetzler), University of Cambridge, Free School Lane, Cambridge, United Kingdom.
AJOG Glob Rep. 2025 Feb 16;5(2):100465. doi: 10.1016/j.xagr.2025.100465. eCollection 2025 May.
Globally, ∼2 million babies are stillborn annually, many in low- and middle-income countries. We aim to understand the experience of obstetricians caring for parents who experience stillbirth and perinatal loss across global settings.
Medline via Ovid, Embase via Ovid, CINAHL via Ebsco, PsychINFO via Ebsco, Scopus, Web of Science Core Collection, and ASSIA via Proquest were searched, database inception-June 2024.
Studies with qualitative components describing experiences of obstetricians providing stillbirth care in any global setting.
The Critical Appraisal Skills Programme checklist for qualitative research was utilized to conduct quality assessment. NVivo software was employed for inductive coding and thematic analysis.
Thirteen qualitative studies from both low- and high-resource settings met the inclusion criteria for meta-synthesis. We identified several major themes including the emotional burdens experienced by obstetricians providing stillbirth care, the challenges of patient-provider interactions following adverse outcomes, and a lack of support and resources. Obstetricians across global settings felt devastation, guilt, blame, and a sense of personal responsibility following stillbirth. Obstetricians struggled to navigate the burden of expectation placed on their overall provision of care and tended to question their own professional competence. A subset of obstetricians felt unprepared for the complexity of patient-provider interactions following stillbirth.
Obstetricians experienced complex and conflicting emotions, citing high emotional burden from managing stillbirth cases. Obstetricians identified lack of training and support for providing bereavement care across healthcare settings, indicating a gap that should be filled by stillbirth and bereavement care interventions and education in obstetrical training programs across global settings. Infrastructure for bereavement care training and support systems for obstetricians are crucial to improve the quality of stillbirth and perinatal loss care and prevent an exodus of needed providers for women's care worldwide.
全球范围内，每年约有200万婴儿死产，其中许多发生在低收入和中等收入国家。我们旨在了解全球各地产科医生照顾死产和围产期死亡患儿父母的经历。
通过Ovid检索Medline、通过Ovid检索Embase、通过Ebsco检索CINAHL、通过Ebsco检索PsychINFO、Scopus、Web of Science核心合集以及通过Proquest检索ASSIA，检索时间为数据库建立至2024年6月。
包含定性部分且描述了全球任何环境下产科医生提供死产护理经历的研究。
采用定性研究的批判性评估技能计划清单进行质量评估。使用NVivo软件进行归纳编码和主题分析。
来自资源丰富和资源匮乏地区的13项定性研究符合元综合分析的纳入标准。我们确定了几个主要主题，包括提供死产护理的产科医生所经历的情感负担、不良结局后医患互动的挑战以及支持和资源的缺乏。全球各地的产科医生在死产后都会感到悲痛、内疚、自责和个人责任感。产科医生努力应对对其整体护理工作所寄予的期望带来的负担，并往往质疑自己的专业能力。一部分产科医生对死产后医患互动的复杂性感到准备不足。
产科医生经历了复杂且相互矛盾的情绪，称处理死产病例带来了沉重的情感负担。产科医生指出，在整个医疗环境中，缺乏提供丧亲护理的培训和支持，这表明全球产科培训项目中的死产和丧亲护理干预及教育应填补这一空白。丧亲护理培训基础设施和产科医生支持系统对于提高死产和围产期死亡护理质量以及防止全球范围内妇女护理所需医疗人员外流至关重要。
