P12 - Midwives, The Military, and Pregnancy... Loss

Abstract

Midwives have an important role in optimising health outcomes through individualised holistic maternity care particularly for women experiencing complications, including the 1 in 5 pregnancies that end in loss. Midwives are trained to acknowledge social determinants of health and identify certain women as having special challenges and needs in pregnancy, women within the Armed Forces are not among them. An integrated literature review was attended to review the challenges of military culture and how it impacts pregnancy and how detrimental this could be in the case of pregnancy loss. Military life pose many challenges including postings leading to isolation from family and friends and deployment leading to uncontrolled spousal absence. Service women and civilian spouse also experience different pathways of care compared to the civilian population. The impact of the challenges in military life increased contributing factors and the rate of anxiety and depression, which is heightened during periods of deployment. Challenges accessing care were highlight due to physicians not understanding military culture and offering unhelpful care and advice. In pregnancy this resulted in an increase rate of preterm birth, low birth weight neonates and perinatal anxiety and depression. In the event of pregnancy loss, women reported their spouse was their greatest support and the individual and co-grieving strengthened their relationship and allowed post traumatic growth, while family support was also highly valued. Culminated with the impact of military life and in the event of pregnancy loss and deployment coinciding this poses a detrimental void. While midwives are unable to change the challenges of military life, receiving the education to understand and appreciate them; and recognise military families at booking in creating a holistic care plan has the opportunity to create improved outcomes for these women.