D Nuzum1, S Meaney, K O'Donoghue. 1. Anu Research Centre, Department of Obstetrics and Gynaecology, University College Cork, Cork University Maternity Hospital, Wilton, Cork, Ireland.
Abstract
OBJECTIVE: To explore the personal and professional impact of stillbirth on consultant obstetrician gynaecologists. DESIGN: Semi-structured in-depth qualitative interviews. SETTING: A tertiary university maternity hospital in Ireland with a birth rate of c. 9000 per annum and a stillbirth rate of 4.6/1000. SAMPLE: Purposive sample of eight consultant obstetrician gynaecologists (50% of consultant obstetrician gynaecologists in the hospital). METHODS: Semi-structured in-depth interviews analysed by Interpretative Phenomenological Analysis. (IPA) IPA is a methodology for exploring human experience and its meaning for the individual. MAIN OUTCOME MEASURES: The lived experiences, personal feelings and professional impact of stillbirth on consultant obstetrician gynaecologists. RESULTS: Stillbirth was identified as amongst the most difficult experiences for consultants. Two superordinate themes emerged: the human response to stillbirth and the weight of responsibility. The human response to stillbirth was characterised by the personal impact of stillbirth for consultants and, in turn, how that shapes the care they provide. The weight of professional responsibility was characterised by the sense of professional burden and the possibility of a medico-legal challenge-mostly for those who are primarily gynaecologists resulting in the question 'what have I missed?'. CONCLUSIONS: Despite the impact of stillbirth, no consultant has received formal training in perinatal bereavement care. This study highlights a gap in training and the significant impact of stillbirth on obstetricians, professionally and personally. The provision of support, ongoing education, bereavement training and self-care is recommended. Medico-legal concerns following stillbirth potentially impact on care, warranting further research.
OBJECTIVE: To explore the personal and professional impact of stillbirth on consultant obstetrician gynaecologists. DESIGN: Semi-structured in-depth qualitative interviews. SETTING: A tertiary university maternity hospital in Ireland with a birth rate of c. 9000 per annum and a stillbirth rate of 4.6/1000. SAMPLE: Purposive sample of eight consultant obstetrician gynaecologists (50% of consultant obstetrician gynaecologists in the hospital). METHODS: Semi-structured in-depth interviews analysed by Interpretative Phenomenological Analysis. (IPA) IPA is a methodology for exploring human experience and its meaning for the individual. MAIN OUTCOME MEASURES: The lived experiences, personal feelings and professional impact of stillbirth on consultant obstetrician gynaecologists. RESULTS: Stillbirth was identified as amongst the most difficult experiences for consultants. Two superordinate themes emerged: the human response to stillbirth and the weight of responsibility. The human response to stillbirth was characterised by the personal impact of stillbirth for consultants and, in turn, how that shapes the care they provide. The weight of professional responsibility was characterised by the sense of professional burden and the possibility of a medico-legal challenge-mostly for those who are primarily gynaecologists resulting in the question 'what have I missed?'. CONCLUSIONS: Despite the impact of stillbirth, no consultant has received formal training in perinatal bereavement care. This study highlights a gap in training and the significant impact of stillbirth on obstetricians, professionally and personally. The provision of support, ongoing education, bereavement training and self-care is recommended. Medico-legal concerns following stillbirth potentially impact on care, warranting further research.
Authors: Paul A Gardiner; Alison L Kent; Viviana Rodriguez; Aleena M Wojcieszek; David Ellwood; Adrienne Gordon; Patricia A Wilson; Diana M Bond; Adrian Charles; Susan Arbuckle; Glenn J Gardener; Jeremy J Oats; Jan Jaap Erwich; Fleurisca J Korteweg; T H Nguyen Duc; Susannah Hopkins Leisher; Kamal Kishore; Robert M Silver; Alexander E Heazell; Claire Storey; Vicki Flenady Journal: BMC Pregnancy Childbirth Date: 2016-11-25 Impact factor: 3.007