2017 Volume 31 Issue 1 Pages 88-97
Objectives
This study aims to elucidate midwives' awareness of the psychology and needs of women during childbirth after losing a previous child (hereinafter, “women who lost a previous child”) due to childbirth related malpractice, to elucidate the current situations and issues of support at facilities, and to examine the relevant factors for awareness of midwives in supporting the desirable care of women who lost a previous child.
Materials and Methods
A total of 145 facilities among the hospitals in Japan that handle childbirth were contacted at random, and were asked to participate in this survey. Self-administered questionnaires were distributed to 251 midwives working at 18 facilities who consented to participate in our study concerning the following points: knowledge, experience, understanding, and awareness about subsequent childbirth in women who had lost a previous child. This is a quantitative descriptive, and a relationship exploratory cross-sectional study. Analysis was performed using Spearman's rank-correlation coefficient and analysis of covariance structure.
Results
We obtained 139 responses (55.4% collection rate), of which there were a few midwives who had knowledge and experience about women who lost a previous child, and 7 midwives (5.0%) who had the experience of caring for women during subsequent childbirth. With regard to the understanding of necessary support for the subsequent childbirth in women who lost a previous child, although there were categories for which all the respondents shared affirmative awareness, 68 midwives (51.5%) indicated negative awareness for the following category: “physicians or midwives who are well-acquainted with malpractice or the cases where children were lost due to malpractice attend the subsequent childbirth”. Concerning the relevant factors of midwives' awareness in the desirable care of women who lost a previous child, “more than negative feeling,” the standardized coefficient from “understanding of necessary support” to “awareness of the desirable care” of women who lost a previous child was as high as −0.12 and 0.67, respectively.
Conclusion
With regard to midwives' awareness of the psychology and needs of women who lost a previous child, more than half indicated negative awareness for the following category: “physicians or midwives who are well-acquainted with malpractice or the children who were lost because of malpractice attend to the subsequent childbirth.” It is necessary to perform an investigation including factors related to the psychology of midwives that led to such an awareness. As for the current situations and issues of support at facilities for subsequent childbirth in women who lost a previous child, midwives' knowledge and experience about women who lost a previous child and experience in subsequent childbirth care are limited. Thus, midwives must make efforts to understand the issues by utilizing their knowledge and experience. Regarding the relevant factors related to midwives' awareness in the desirable care of women who lost a previous child, the results suggest that improving the “understanding of necessary support” for women who lost a previous child would lead to “awareness in the desirable care.”
