Midwives holding the space for women undergoing termination of pregnancy: A qualitative inquiry |
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| Affiliation: | 1. Department of Psychology, College of Healthcare Sciences, James Cook University, Australia, @BrianLaw_Psych;2. School of Human Sciences (Exercise and Sports Science), Faculty of Science, The University of Western, Australia;3. Division of Psychiatry, School of Medicine, The University of Western, Australia;4. Peel and Rockingham, Kwinana Mental Health Service, Western Australia, Australia;5. Ngala, Western Australia, Australia;6. Telethon Kids Institute, Western Australia, Australia;7. Cairnmillar Institute, Victoria, Australia;1. Department Health Care, Knowledge Centre Brussels Integrated Care, Erasmus Brussels University of Applied Sciences and Arts, Laarbeeklaan 121, 1090 Brussels, Belgium;2. Faculty of Medicine and Pharmacy, Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium;3. Faculty of Physical Education and Physiotherapy, Rehabilitation Research, Vrije Universiteit Brussel (VUB), Pleinlaan 2, 1050 Brussels, Belgium;4. Faculty of Medicine and Pharmacy, Department of Obstetrics and Prenatal Medicine, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium;5. Department of Obstetrics and Prenatal Medicine, University Hospital Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium;1. The University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, Queensland, 4556, Australia;2. Southern Cross University, Gold Coast Airport, Terminal Dr, Bilinga, Queensland, 4225, Australia;1. South Western Sydney Local Health District, NSW, Australia;2. Ingham Institute for Applied Medical Research, Western Sydney University, NSW, Australia;3. School of Nursing and Midwifery, Western Sydney University, NSW, Australia |
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| Abstract: | ProblemHospital midwives are the main care givers for women undergoing termination of pregnancy after 20 weeks. Midwives’ role and potential impact of regular involvement in termination of pregnancy (TOP) are poorly understood.SettingNew Zealand.BackgroundTOP after 20 weeks may be performed to save a woman’s life or preserve her physical and mental health. Throughout the process midwives play a key role in supporting women’s complex psychological and clinical needs.ObjectiveTo gain a deeper understanding of the role of midwives in TOP care after 20 weeks, including the support they might need and the impacts caring for women who are having a TOP may have on them.MethodsEight midwives from two District Health Boards were interviewed about their experiences of caring for women having a TOP after 20 weeks. Transcripts were analysed by applying a hermeneutic-phenomenological lens.FindingsThree themes emerged: “A different kind of midwife”, “Staying true to oneself” and “Melting an Iceberg”. TOP care is a different role within midwifery as midwives facilitate death in the space of birth. Immersing themselves in women’s emotional space they create meaningful connections to support their complex needs and provide a positive birth experience. Yet, midwives are unprepared for the emotional effects of repeatedly caring for women undergoing TOP. Lacking appropriate support they can experience increasing, lasting grief.ConclusionMidwives’ experiences of providing TOP care are complex, intense and have lifelong impact. Their role in the context of TOP is highly specialised and must be valued and supported. |
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| Keywords: | Midwifery Midwives Late termination of pregnancy Abortion care Qualitative |
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