Termination for fetal defects: The effect on midwifery staff

Abstract

This study looks at the experiences of staff caring for women who have a late termination of pregnancy for fetal abnormality. Grounded theory was used to look at how staff coped with the experiences and the impact on the individual, their professional role and the organization. A total of 23 staff from a wide cross section of the professions within the directorate of obstetrics and gynaecology took part. The analysis showed a process of caring that evolved over time and was dependent on the emotional reaction of the individuals and families to the news of the fetal abnormality. The authors describe the process in a staged model called ‘the experience of the evolution of caring’. This was seen as a reflective and dynamic model. Three main stages are identified in the model through several main categories such as support, boundaries and limitations, and detachment. These formed the basis for the experience of caring. A core category identified was that of ‘doing the right thing’.

Interaction between caregivers and families expecting a malformed child

“…1999). It is important to help parents identify and find sources of psychological support, and encourage the couple to share their experiences (Jörgensen et al . 1985, Dallaire et al .…”

“…1996, Posa et al . 1997, Posa 1998), and relatively few nursing studies have addressed the subject (Lemons & Brock 1990, Sandelowski & Jones 1996, Schroeder 1996, Chandler & Smith 1998, Bourguignon et al . 1999, Askey & Moss 2001).…”

Termination of pregnancy services: experiences of gynaecological nurses

“…In a United Kingdom (UK) study, Askey and Moss (2001, n = 23) focussed on the experience of working with women having TOP for foetal abnormality and found that staff appeared to follow a process described as ‘the evolution of caring’. Their ability to handle a late termination increased with greater exposure, with staff over time being able to be more distant.…”

“…Interestingly, the other ways of coping described in the current study concerned actively restricting thoughts and feelings, switching off and compartmentalizing, and keeping emotions under control. In their three‐stage model of the process of being able to care for women undergoing TOP for foetal abnormality, Askey and Moss (2001) described the final stage as staff being able to distance themselves.…”

“…Specific events have also been highlighted in the existing TOP literature as influencing staff attitudes and experiences. Askey and Moss’s (2001) model of the evolution of care describes how regression to an earlier stage may occur as the result of work or personal circumstances. Nurses working in palliative care have also described how experiences of their own relatives dying had affected their caregiving (Ablett & Jones 2007).…”