The experience of vasa praevia for Australian midwives: A qualitative study

Abstract

BackgroundVasa praevia can cause stillbirth or early neonatal death if it is not diagnosed antenatally and managed appropriately. Experiencing undiagnosed vasa praevia during labour is challenging and traumatic for women and their care providers. Little is known about the experiences of midwives who care for these women. AimTo investigate the experience of Australian midwives caring for women with undiagnosed vasa praevia during labour and birth. MethodsA qualitative descriptive study was conducted with midwives in Australia who had cared for at least one woman with vasa praevia during 2010–2016. Semi-structured in-depth telephone interviews were conducted and analysed using thematic analysis. FindingsTwelve of the 20 midwives interviewed were involved in a neonatal death and/or near-miss due to vasa praevia. There was one over-arching theme, which described the ‘devastating and dreadful experience’ for the midwives. This had two inter-related categories of feeling the personal impacts and addressing the professional processes. Feeling scared, shocked, and guilty described how the experience took its toll on the midwives personally. The professional processes included working in organised chaos; feeling for the parents; finding communication to be hard; and, doing their best to save the baby. DiscussionCaring for women who experienced ruptured vasa praevia had a profound impact on the emotional and professional well-being of midwives even when the baby survived. ConclusionRuptured vasa praevia was recognised as a traumatic experience that warrants serious considerations from maternity care providers, managers and policy makers. Midwives should be supported and adequately prepared to cope with traumatic events.