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Parents’ experiences and expectations of care in pregnancy after stillbirth or neonatal death: a metasynthesis
Author(s) -
Mills TA,
Ricklesford C,
Cooke A,
Heazell AEP,
Whitworth M,
Lavender T
Publication year - 2014
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.12656
Subject(s) - pregnancy , anxiety , coping (psychology) , psychology , medicine , qualitative research , nursing , clinical psychology , family medicine , psychiatry , sociology , social science , genetics , biology
Background Pregnancy after perinatal death is characterised by elevated stress and anxiety, increasing the risk of adverse short‐term and long‐term outcomes. Objectives This metasynthesis aimed to improve understanding of parents’ experiences of maternity care in pregnancy after stillbirth or neonatal death. Search strategy Six electronic databases were searched using predefined search terms. Selection criteria English language studies using qualitative methods to explore the experiences of parents in pregnancy after perinatal loss, were included subject to quality appraisal framework. Data collection and analysis Searches were initiated in December 2011 and finalised in March 2013. Studies were synthesised using an interpretive approach derived from meta‐ethnography. Main results Fourteen studies were included in the synthesis, graded A (no or few flaws, high trustworthiness; n = 5), B (some flaws, unlikely to affect trustworthiness; n = 5) and C (some flaws, possible impact on trustworthiness; n = 4). Three main themes were identified; co‐existence of emotions, helpful and unhelpful coping activities and seeking reasssurance through interactions. Conclusion Parents’ experiences of pregnancy are profoundly altered by previous perinatal death; conflicted emotions, extreme anxiety, isolation and a lack of trust in a good outcome are commonly reported. Emotional and psychological support improves parents’ experiences of subsequent pregnancy, but the absence of an evidence base may limit consistent delivery of optimal care within current services.