Work

A time/space bubble: Expectant parents’ experience of birth after termination of pregnancy due to fetal anomaly in a midwifery-led, obstetric unit for prenatal loss

Year: 2024

Type: article

Abstract: • Parents undergoing termination of pregnancy due to fetal anomaly needs specialised and individualised care in units designed as private and protected areas. • Findings illustrate that time is not only “time available”, but was also as a time/space bubble of extraordinary experiences, where absurdity and brutality co-exist with beauty and pride. • Organisational priority of midwifery specialisation and education is important to accommodate the diversity of needs in parents undergoing termination of pregnancy due to fetal anomaly. Termination of pregnancy due to a fetal anomaly is a challenging and mentally stressful experience, associated with trauma-related stress, depression and symptoms of complicated grief. It differs from other types of pregnancy loss because of the role of active decision-making. Expectant parents depend on caring and experienced staff to guide them during a time full of ambiguity and contrasting emotions. This study examines how expectant parents experience the process of birth with termination of pregnancy due to fetal anomaly at a specialised unit for prenatal loss. Data was generated from semi-structured interviews with 11 women and 9 male partners, one to five months after termination of pregnancy. Three themes were identified 1) Suspended time/space bubble ; the unit for prenatal loss was described as a time-space bubble, that promoted a sense of meaning, a feeling of togetherness and an awareness of parallel worlds, 2) The midwife matters ; participants emphasised midwives’ 'invisible', chronological and individualised practice, making it possible to be present and in the process, and 3) Meeting and spending time with the fetus/baby ; participants’ responses and relation to the fetus were very different, with most of them embracing the fetus as a baby, grateful for the opportunity to have time together. The findings from this study suggest a need for specialised midwives dedicated to prenatal loss, in units designed as private and protected spaces to accommodate the requirements of parents undergoing termination of pregnancy due to fetal anomaly.

Source: Midwifery

DOI: 10.1016/j.midw.2024.104189

Authors: Maiken F. Damm, Stina Lou, Puk Sandager, Ida Vogel, Christina Prinds, Dorte Hvidtjoern