期刊论文详细信息
BMC Pregnancy and Childbirth
Mothers’ accounts of their stillbirth experiences and of their subsequent relationships with their living infant: an interpretative phenomenological analysis
Jacqueline Blissett2  Gillian Harris2  Michael Larkin2  A. Meltem Üstündağ – Budak1 
[1] The School of Psychology, Bahçeşehir University, Istanbul, Turkey;The School of Psychology, University of Birmingham, Birmingham, Edgbaston, UK
关键词: Interpretative phenomenological analysis;    IPA;    Continuing bonds;    Loss and grief;    Parenting following stillbirth;    Subsequent pregnancy following stillbirth;    Stillborn;    Stillbirth;   
Others  :  1228696
DOI  :  10.1186/s12884-015-0700-3
 received in 2015-01-22, accepted in 2015-10-08,  发布年份 2015
PDF
【 摘 要 】

Background

Due to contradictory findings regarding the effects of seeing and holding stillborn infants on women’s worsening mental health symptoms, there is a lack of clear of guidance in stillbirth bereavement care. Although some current research examines this phenomenon we are still not certain of the meaning of such experiences to women and what effects there may be on her subsequent parenting. Thus the present study focuses on the meaning of the stillbirth experience to women and its influence on the subsequent pregnancy and subsequent parenting from the mothers’ own experiences.

Methods

A purposive sample of six women who experienced a stillbirth during their first pregnancy and who then went on to give birth to a living child after a further pregnancy, took part in email interviews, providing rich and detailed experiential narratives about both the stillbirth itself, and their relationship with their living child. An Interpretive Phenomenological Analysis was carried out in order to focus on mothers making sense of such experiences.

Results

Analysis of written accounts led to the development of three overarching themes. In ‘Broken Canopy’, ‘How This Happened’ and ‘Continuing Bonds’, their accounts revealed an ongoing process where women accepted a new ‘unsafe’ view of the world, re-evaluated their view of self and others, and established relationships with both the deceased and the living infant.

Conclusions

This study provided an insight into the stillbirth experience of mothers and its meaning to them with an existential focus. Typically the mother struggled with the contradictory process of accepting the existence of her deceased baby (this baby once lived) while being aware of the nonexistence (this baby). Meeting the dead baby was a crucial point at which the mother started processing her grief. The importance of individual differences in dealing with stressful situations was highlighted in terms of attachment strategies. Subsequent parenting experiences of mothers were very much influenced by their own previous experiences. Although some mothers managed to integrate this trauma into their life some remained very concerned and anxious about future and this anxiety then translated into their parenting experiences.

【 授权许可】

   
2015 Üstündağ – Budak et al.

【 预 览 】
附件列表
Files Size Format View
20151018024253910.pdf 506KB PDF download
【 参考文献 】
  • [1]Lewis E, Page A. Failure to mourn a stillbirth: an overlooked catastrophe. Br J Med Psychol. 1978; 51(3):237-241.
  • [2]Hughes P, Turton P, Hopper E, Evans CDH. Assessment of guidelines for good practice in psychosocial care of mothers after stillbirth: a cohort study. Lancet. 2002; 360(9327):114-118.
  • [3]Brabin P. To see or not to see that is the question. Challenging good-practice bereavement care after a baby is stillborn: The case in Australia. Grief Matters. 2004; 7(2):28-33.
  • [4]National Institute for Health and Clinical Excellence: Antental and postnatal mental health. Clinical management and service guidance. In: NICE clinical gudeline 45; 2007.
  • [5]Facchinetti F, Dekker GA, Baronciani D, Saade G. Stillbirth: Understanding and Management. Informa Healthcare, London; 2009.
  • [6]Cacciatore J, Radestad K, Froen FJ. Effects of contact with stillborn babies on maternal anxiety and depression. Birth. 2008; 35(4):313-320.
  • [7]Radestad I, Surkan PJ, Steineck G, Cnattingius S, Onelov E, Dickman PW. Long-term outcomes for mothers who have or have not held their stillborn baby. Midwifery. 2009; 25(4):422-429.
  • [8]Erlandsson K, Warland J, Cacciatore J, Rådestad I. Seeing and holding a stillborn baby: Mothers' feelings in relation to how their babies were presented to them after birth—Findings from an online questionnaire. Midwifery. 2013; 29(3):246-250.
  • [9]Ryninks K, Roberts-Collins C, McKenzie-McHarg K, Horsch A. Mothers' experience of their contact with their stillborn infant: An interpretative phenomenological analysis. BMC Pregnancy Childbirth. 2014; 14(1):203-213. BioMed Central Full Text
  • [10]Kelley MC, Trinidad SB. Silent loss and the clinical encounter: Parents’ and physicians’ experiences of stillbirth–a qualitative analysis. BMC Pregnancy Childbirth. 2012; 12(1):137-151. BioMed Central Full Text
  • [11]Downe S, Schmidt E, Kingdon C, Heazell AE. Bereaved parents’ experience of stillbirth in UK hospitals: a qualitative interview study. BMJ Open. 2013; 3(2):002237.
  • [12]Lamb EH. The impact of previous perinatal loss on subsequent pregnancy and parenting. J Perinat Educ. 2002; 11(2):33-40.
  • [13]Roth S, Cohen LJ. Approach, avoidance, and coping with stress. Am Psychol. 1986; 41(7):813-819.
  • [14]Côté-Arsenault D, Marshall R. One foot in-one foot out: Weathering the storm of pregnancy after perinatal loss. Res Nurs Health. 2000; 23:473-485.
  • [15]Hughes P, Turton P, Evans CDH. Stillbirth as a risk factor for anxiety and depression in the next pregnancy: does time since loss make a difference. BMJ. 1999; 318(7200):1721-1724.
  • [16]Hughes P, Turton P, Hopper E. Disorganised attachment behaviour among infants born subsequent to stillbirth. J Child Psychol Psychiatry. 2001; 42:791-801.
  • [17]Turton P, Badenhorst W, Pawlby S, White S, Hughes P. Psychological vulnerability in children next‐born after stillbirth: a case–control follow‐up study. J Child Psychol Psychiatry. 2009; 50(12):1451-1458.
  • [18]Warland J, O'Leary J, McCutcheon H, Williamson V. Parenting paradox: parenting after infant loss. Midwifery. 2011; 27(5):163-169.
  • [19]George C, Kaplan N, Main M. Adult Attachment Interview, Unpublished protocol. Department of Psychology; University of California, Berkeley; 1984.
  • [20]Smith LT. On tricky ground: researching the native in the age of uncertainty. In: Handbook of Qualitative Research. 3rd ed. Lincoln ND, editor. Sage Publications, Thousand Oaks; 2005: p.85-107.
  • [21]Smith JA, Flowers P, Larkin M. Interpretative Phenomenological Analysis: Theory Method and Research. Sage, London; 2009.
  • [22]Eatough V, Smith JA. Interpretative phenomenological analysis. In: The Sage handbook of qualitative research in psychology. Willig C, Stainton-Rogers W, editors. Sage, London; 2008: p.179-194.
  • [23]Larkin M, Thompson A. Interpretative Phenomenological Analysis. In: Qualitative research methods in mental health and psychotherapy: An introduction for students and practitioners. Harper D, Thompson A, editors. Wiley, Oxford; 2012: p.110-116.
  • [24]Yalom ID. Existential psychotherapy. Basic Books, New York; 1980.
  • [25]Janoff-Bulman R. Shattered assumptions: Towards a new psychology of trauma. Free Press, New York; 1992.
  • [26]Côté-Arsenault D, Donato K. Restrained expectations in late pregnancy following loss. JOGNN. 2007; 36:550-557.
  • [27]Linley PA, Joseph S. Toward a theoretical foundation for positive psychology in practice. In: Positive psychology in practice. Linley PA, Joseph S, editors. Wiley, Hoboken; 2004: p.713-731.
  • [28]Davis CG, Nolen-Hoeksema S. Loss and Meaning How Do People Make Sense of Loss? Am Behav Sci. 2001; 44(5):726-741.
  • [29]Thomadaki O. How mothers experience personal growth after a perinatal loss. Psychology Department, City University; 2012.
  • [30]Cacciatore J. The unique experiences of women and their families after the death of a baby. Soc Work Healthcare. 2010; 49:134-148.
  • [31]Lichtenthal WG, Currier JM, Neimeyer RA, Keesee NJ. Sense and significance: a mixed methods examination of meaning-making following the loss of one’s child. J Clin Psychol. 2010; 66:791-812.
  • [32]O'Leary J, Warland J. Intentional parenting of children born after a perinatal loss. J Loss and Trauma. 2012; 17(2):137-157.
  • [33]Weiss R. Grief, bonds and relationships. In: Handbook of bereavement research. Stroebe M, Hansson R, Stroebe W, Schut H, editors. American Psychological Association, Washington; 2001: p.47-62.
  • [34]Bowlby J. Attachment and loss: Loss. Basic Books, New York; 1969.
  • [35]Dozier M, Kobak RR. Psychophysiology in attachment interviews: Converging evidence for deactivating strategies. Child Dev. 1992; 63(6):1473-1480.
  • [36]Stroebe M, Stroebe W, van de Schoot R, Schut H, Abakoumkin G, Li J. Guilt in Bereavement 2014. The Role of Self-Blame and Regret in Coping with Loss. PLoS One. 2014; 9(5):e96606.
  • [37]Forrest GC, Standish E, Baum JD. Support after perinatal death: a study of support and counselling after perinatal bereavement. BMJ. 1982; 285(6353):1475-1479.
  • [38]Nichols JA. Perinatal death. In: Disenfranchised Grief Recognizing Hidden Sorrow. Doka KJ, editor. Lexington Books, New York; 1989: p.117-126.
  • [39]O’Leary J, Thorwick C. Impact of pregnancy loss on subsequent pregnancy. In: Loss During Pregnancy or in the Newborn Period. Woods JR, Woods JE, editors. Jannetti, Pitman; 1997: p.431-463.
  • [40]Surkan PJ, Rådestad I, Cnattingius S, Steineck G, Dickman PW. Social support after stillbirth for prevention of maternal depression. Acta Obstet Gynecol Scand. 2009; 88(12):1358-1364.
  • [41]Cacciatore J. Psychosocial care. In: Stillbirth: Prediction, Prevention, and Management. Spong C, editor. Wiley-Blackwell, Hoboken; 2011: p.203-228.
  • [42]Cacciatore J, Schnebly S, Froen JF. The effects of social support on maternal anxiety and depression after stillbirth. Health Soc Care Community. 2009; 17(2):167-176.
  • [43]Leon I. When a baby dies: Psychotherapy for pregnancy and newborn loss. Yale University Press, New Haven; 1990.
  • [44]Klass D, Silverman PR, Nickman SL. Continuing bonds: New understanding of grief. Taylor & Francis, Washington DC; 1996.
  • [45]Bonanno GA, Kaltman S. Toward an integrative perspective on bereavement. Psychol Bull. 1999; 125(6):760-766.
  • [46]Hesse E, Main M. Frightened, threatening, and dissociative (FR) parental behavior as related to infant D attachment in low-risk samples: Description, discussion, and interpretations. Dev Psychopathol. 2006; 18:309-343.
  • [47]Klass D, Walter T. Processes of grieving: How bonds are continued. In: Handbook of bereavement research: Consequences, coping and care. Stroebe MS, Hansson RO, Stroebe W, Schut H, editors. APA, Washington; 2001: p.431-448.
  • [48]Field NP. Whether to relinquish or maintain a bond with the deceased. In: Handbook of bereavement research and practice: advances in theory and intervention. Stroebe MS, Hansson RO, Schut H, Stroebe W, editors. APA, Washington; 2008: p.113-129.
  • [49]Field NP, Filanosky C. Continuing bonds risk Factors for complicated grief and adjustment to bereavement. Death Stud. 2010; 34(1):1-29.
  • [50]Turton P, Evans C, Hughes P. Long-term psychosocial sequelae of stillbirth: phase II of a nested case–control cohort study. Arch Women Ment Health. 2009; 12(1):35-41.
  • [51]Kübler-Ross E. On Death and Dying. Routledge, London; 1969.
  • [52]Bonanno GA. Loss, trauma, and human resilience. Am psycho. 2004; 59(1):20-28.
  • [53]Warland, J, Davis, DL: Caring for families experiencing stillbirth: A unified position statement on contact with the baby. [http://missfoundation.org/news/StillbirthContactwBaby_position_statement.pdf]. Accessed 10 July 2015.
  • [54]Phipps S. The subsequent pregnancy after stillbirth: Anticipatory parenthood in the face of uncertainty. Intl J Psychiat Med. 1985; 15(3):243-264.
  • [55]Robertson PA, Kavanaugh K. Supporting parents during and after a pregnancy subsequent to a perinatal loss. J Perinat Neonatal Nurs. 1998; 12(2):63-66.
  • [56]Price SK. Women and reproductive loss: Client-worker dialogues designed to break the silence. Soc Work. 2008; 53(4):367-376.
  • [57]Main M, Solomon J. Discovery of an insecure disorganized/disoriented attachment pattern: procedures, findings and implications for the classification of behavior. In: Affective development in infancy. Braxelton T, Yogman M, editors. Ablex, Norwood; 1986: p.95-124. Norwood
  文献评价指标  
  下载次数:4次 浏览次数:13次