.1 Introduction
The Literature Review discussed in this chapter commences with a discussion on the prevalence of second trimester miscarriage, risk factors associated with second trimester miscarriage and hospital care during miscarriage. Next the theoretical approaches that have informed our thinking on grief and bereavement are discussed; such as the contemporary theories of grief and bereavement (Stroebe and Schut 1999; Worden, 2009) while also drawing on the earlier work of Freud (1925), Bowlby (1980) and Parkes (1972). The psychological aspects of pregnancy loss and fathers’ experiences of miscarriage and are then discussed. The chapter concludes with a discussion of the literature in relation to health care professionals’ experiences
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The databases searched were PubMed, CINAHL plus (EBSCO), EMBASE (Elsevier) and filtered for English language only with no time restriction. A combination of the key words listed below was used as part of the search strategy. Medical care which included the following key words: second trimester miscarriage, late miscarriage, spontaneous abortion, mid trimester loss, medical care, treatments, pain relief or analgesia, hospital care. theories of grief and loss which included the following key words; grief, bereavement, theories, models. Parents’ experiences of perinatal loss which included the following key words: mothers’ experiences, fathers’ experiences and parents’ experiences of perinatal loss, second trimester miscarriage, miscarriage, still birth, neonatal death and hospital …show more content…
The rate of second trimester miscarriage is estimated at 1-2% of recognised pregnancies (Edlow et al., 2007, Wyatt et al., 2005). Blohm et al. (2008) found that miscarriage occurred in 12% of all pregnancies and one quarter of women who had been pregnant by 39 years of age had suffered at least one miscarriage. Research with a sample of 5806 women by Hure et al. (2012) found a miscarriage rate of 25 per 100 live births. The majority of miscarriages take place during the first trimester of pregnancy (HSE, 2014). Westin et al. (2007) found that in low risk women, the risk of pregnancy loss in the second trimester was 0.5%. A recent study conducted in Cork found that the rate of pregnancy loss between 14-24 weeks was approximately 0.5% (Morris et al., 2014). A more recent study conducted in a large Dublin maternity hospital reported a rate of second trimester pregnancy loss of 0.8% (Cullen et al., 2016).
2.4 Risk factors associated with second trimester miscarriage
While there is a dearth of research examining risk factors specifically for second trimester miscarriage there are a number of research studies examining risk factors for miscarriage, recurrent miscarriages and stillbirths. Several risk factors have been associated with an increased risk of miscarriage and or stillbirth; these include increased maternal age, obesity, smoking, caffeine
People aren’t always what we think they are and yet we still expect people to be the stereotypes society runs off of. Maycomb too suffers from this “usual disease” especially with regard to Boo Radley. Everyone in Maycomb County makes fun of Boo, Arthur Radley, without even knowing him: “Boo was about six and a half feet tall […]; he dined on raw squirrels...” (13). This quote explains one of the many urban myths Maycomb and the children have built around Boo.
Historically perinatal loss such as stillborn is rarely a topic of discussion. (Avelin, Erlandsson, Hildingsson, & Rådestad, 2011). Stillborn loss was not viewed as an problem, and was expected for mothers to forget about the baby, and have another one, while siblings were told to forget about the baby and not talk about the loss (Avelin et al., 2011). Perinatal loss responses can be vary widely as it covers variety of loss from pregnancy to birth within a few weeks, but most often it is an unexpected loss for many families who typically do not know what to do, what to expect and how to handle grief (O’leary & Warland, 2013). Furthermore, there is very little information on Stillbirth experiences especially about men who lose their child(Bonnette & Broom, 2012). Experiencing the loss of a child can be very difficult and often complicate grief which can affect parents social well being (Kersting & Wagner, 2012). In pregnancies that follows a loss such as perinatal loss, it has been found that parents experience high levels of psychological distress, anxiety, depression and post-traumatic stress. (O’leary & Warland, 2013; Kersting & Wagner, 2012)
When the parents of a perinatal loss are first informed about their loss, they are instantly put into a stage of shock or disbelief. Most women are unprepared and experience post-traumatic stress disorder and anxiety (Coleman, 2015). It is common for parents to be in denial about the loss of their baby. This can last minutes to years. During this stage, there is little emotion shown. You will rarely see the parents of a perinatal loss crying during the stage of denial.
The purpose of this journal is to examine the core concept of “Grief and Loss” in a patient that I cared for in a previous clinical. This clinical experience will represent this core concept and identify any discrepancies or inconsistencies that can be modified and incorporated to the nursing process. Consistencies will be researched based on articles, clinical experience, and our textbook. Inconsistencies will be analyzed by using our PICOT research. A summary with explored research will be discussed with options to incorporate into future nursing practice.
It’s understood that the shock of not knowing who you could have raised and loved is devastating, a reason why certain hospitals will give the parents an option to spend time with the deceased child in an attempt at offering closure. Additionally, for some people it's not only the loss of the child they are grieving for, but the hopes and dreams they had for it. This type of loss has similar shocking effects to those who have had a miscarriage. Both miscarriages and fetal deaths can affect the
This paper reviews recent studies on the long lasting effect pregnancy loss has on it's families. Research has shown that families have increased risks of developing mental health disorders and strains on previous relationships. As research continues to develop we see that pregnancy and infant loss is taking a social economically toll on the families surviving this tragedy.
Research after research has shown that 10-25% of all clinically recongnized pregnancies end up in a miscarriage, they also have suggested that this figure may be higher due to the fact that some women miscarry, but do not know after ever being
According to the text book Parent-Child Relations: An Introduction to Parenting by Bigner and Gerhardt (2014), miscarriage is the word known for a pregnancy that ends unplanned during the first 20 weeks of pregnancy. The reasons why miscarriage happens varies but there is no exact cause and no exact way to tell when and how it can be prevented. Bigner and Gerhardt (2014) also mention that around 10 to15 percent of known pregnancies are miscarriages. This topic is important to discuss because even though 10 to 15 percent of pregnancies seem like a small amount of miscarriages, it is actually a vast majority. Miscarriage is a difficult challenge that both the mother and the father of the unborn fetus have to go through which is why more individuals need to know more about miscarriage. First I will discuss why miscarriage happens and how it can be preventable. Next, I will discuss the impacts of miscarriage on both the mother and the father. Lastly, I will discuss how parents can cope with the loss of their unborn fetus.
A 2003 article, which gathers several experts’ studies in the Obstetrical and Gynecological Survey, shows that induced abortion also increases the risk of Placenta Previa by 50 percent and doubles the risk of pre-term birth in later pregnancies. Placenta Previa means when the placenta
The effects that impact on anyone that has ever had a miscarriage, is dramatic and as well dealing with the emotional and psychological effects it causes. Not only for a short period of time that this will go on, but it can last all the way till the next time to try to conceive again or for the rest of a women’s life if they never conceive. A woman can develop anxiety from it and the fear of never being able to ever have a baby of her own has a big impact on her relationship with her spouse and friends that have kids of their own. It is not easy going to baby shower after baby shower seeing all the other children walking around and seeing your best friend carrying her first at nine months pregnant. As we all grow up and move on other relationships,
A miscarriage, also known as spontaneous abortion, is the loss of the fetus before it is viable. About 15-20% of all pregnancies end in a miscarriage, often occurring during the first trimester. Miscarriages may occur due to a fertilized egg failing to divide correctly, genetic abnormalities, maternal illnesses, hormone imbalances, toxic chemicals, physical trauma or infections. Usually, however, the cause is unidentified. A stillbirth refers to the death of a fetus after the twentieth week of pregnancy, but before delivery. Approximately 1 in every 160 births is a stillbirth in the United States. In this situation, the baby is born dead, often for no recognizable reason. Poor fetal growth, infections and umbilical cord accidents, however,
A loss of a fetus can only be deemed a miscarriage in the UK so long as it has a gestation date of 23 weeks 6 days, within the first two trimesters of a pregnancy. First-trimester miscarriages account for the majority of miscarriages, occurring in the first 12 weeks of gestation. They account for 20% of the overall rate of miscarriages (Stalder, 2012). Although light vaginal bleeding is relatively common during the first trimester of pregnancy, the most obvious way a woman can suspect that she has miscarried is vaginal bleeding followed by cramps/pain in the lower abdomen (NHS, 2015).
We experience many losses throughout our lives, as loss is inevitable (Horwitz & Wakefield, 2007). Attig (2011) described grief as being a perplexing state, as grief combines components of principle, disposition, and anguish. Bereavement by death has been described as a major psychological trauma, in which the loss is a tragedy unequalled to another experiencing within a similar life scenario (Stroebe & Wolfgang, 1993).
Miscarriage is the most common complication of pregnancy in the United States, occurring in 15-20% of clinically-recognized pregnancies, or ~1,000,000 cases annually. - Despite its frequency, the majority of Americans believe that it is a rare complication occurring in 5% or fewer of all pregnancies. Miscarriage can be an unexpected and emotionally devastating diagnosis for patients and their partners with studies showing that some women may suffer from psychological morbidity for months after the miscarriage and even into subsequent pregnancies. Our recent study revealed that those who have suffered a miscarriage frequently feel guilty, isolated and alone. Additionally, there are widespread misperceptions as to the
According to London et al. (2014), stillbirth is defined as the “death of a fetus or infant from the time of conception through the end of the newborn period 28 days after birth” (p. 481). In 2011, in the country of Taiwan, there were a total of 2,321 stillborn births and it was reported that 60% of the women who experienced this loss suffered from severe postpartum depression within 4 years (Tseng, Chen, & Wang, 2014, p. 219). Although it is known that the mothers of these infants suffer with traumatic stress, follow-ups after stillbirths are rare and there is no community support groups available. There is not much information available on the experience of Taiwanese women who experience a stillbirth nor is there information about the steps taken by these women to recover from their loss. Thus, this study seeks to understand the experiences of these Taiwanese women who have experienced the loss of an infant and how they cope within their society (Tseng et al., 2014, p. 219).