Midwifery care for mothers who have experienced stillbirth : a mixed-methods study on current practices and perceived needs

Abstract

Objective : This study aimed to explore care that supports maternal grief resolution and psychological recovery by (1) clarifying midwives’ current practices in caring for mothers experiencing stillbirth through a quantitative study of item-specific and factor-based implementation rates and (2) identifying the care considered necessary through a qualitative study.

Methods : Applying a mixed-methods approach, a self-administered questionnaire was distributed to 67 midwives in perinatal facilities in Prefecture A. The participants rated 20 care items on a four-point scale. The study conducted descriptive statistics and exploratory factor analysis and inductively analyzed participants’ free-text responses regarding necessary care. Ethical approval was obtained.

Results : The overall response and valid response rates were 54.1% and 45.2%, respectively. Fifteen items (75%) had mean scores ≥3.0. Six factors were extracted ; the highest scores were for “Understanding harms of death avoidance” (M=3.50) and “Providing space to honor the infant as a family member and prepare for farewell” (M=3.47). Necessary care was divided into seven categories, including “Avoiding additional harm to grieving mothers and families” (41.8%).

Conclusion : Though midwives recognize the harm of avoiding death, education for mothers and families is insufficient. Support for family communication barriers and midwives’ dilemmas requires multidisciplinary, longitudinal interventions informed by crisis theory.