Bereaved Mothers Research Articles

A Phenomenological Study of Clinical Stillbirth Management for Grieving Mothers

For any expectant mother, the worst possible outcome of pregnancy is for the baby to die. The experience can lead to various forms of physical and psychosocial morbidity. The purpose of this study was to gain in-depth understanding of the experiences of mothers who suffered stillbirth with a view to improving the clinical management of stillbirth. Semi-structured qualitative interviews were conducted with ten women who had experienced stillbirths within one year prior to the interview. The interviews were recorded and transcribed verbatim. The data were analyzed using Smith’s interpretative phenomenological analysis (IPA) model and ATLAS.ti 8 software. Healthcare professionals identified three main themes: clinical management for stillbirth and bereaved mothers across various roles; public hospitals; and the Jordanian Ministry of Health Policies and Guidelines. The study findings underscore the devastating impact of insensitive and poor-quality care on bereaved mothers, highlighting how it exacerbates their grief and sorrow. These findings emphasize the need for training healthcare providers in perinatal loss and bereavement care, as well as the importance of adopting new policies and guidelines to improve the quality of care provided to bereaved mothers.

Mother's Milk Donation to a Human Milk Bank During Bereavement: Circumstances Associated with Completing the Donation Process.

Background: Bereaved mothers describe positive experiences donating breast milk and negative experiences when not informed of opportunities to donate. Predictors of whether mothers donate milk are unknown, impairing efforts to optimize support in completing donation. Objective: To define circumstances associated with completing mother's milk (MM) donation during bereavement. Methods: A retrospective cohort study included dyads of bereaved mothers and their deceased children if a child's death occurred on-site at a quaternary care children's hospital during 2016-2020, the child had documentation of MM availability, and age at death <24 months. The primary outcome was the completion of MM donation to the milk bank. Multivariate logistic regression measured associations between clinical variables and odds of completion. Results: Of 124 deceased children with documented MM exposure, 34 mothers (28%) of 35 of those children completed MM donation, donating a mean of 13.7 liters (SD 16.8). The child's race/ethnicity documented in the medical record was White for 25 (71%), Black/African American (AA) for 1 (3%), Asian for 1 (3%), and Hispanic/Latino for 8 (23%). Referenced to mothers of White children, being a mother of an AA [OR 0.05 (95% CI: 0.01-0.43)] or Asian [0.08 (0.01-0.75)] child was associated with lower odds of donation. Referenced to mothers delivering full term (≥37 weeks'), mothers delivering <34 weeks showed higher odds [5.0 (1.5-17.5)] of donation. Conclusion: Relatively few bereaved mothers of children with indicators of MM exposure completed donation. The results suggest an opportunity to ensure bereaved mothers are uniformly informed and supported in donating.

Intergenerational Clustering of Under-Five Mortality: A Cohort Perspective in Low- and Middle-Income Countries

A burgeoning demographic literature documents the exceedingly high rates at which contemporary cohorts of women across the Global South experience the death of their children—even amid historic declines in child mortality. Yet, the patterning of maternal bereavement remains underinvestigated, as does the extent to which it replicates across generations of the same family. To that end, we ask: Are the surviving daughters of bereaved mothers more likely to eventually experience maternal bereavement? How does the intergenerational clustering of maternal bereavement vary across countries and cohorts? To answer these questions, we make use of Demographic and Health Survey Program data from 50 low- and middle-income countries, encompassing data on 1.05 million women and their mothers spanning three decadal birth cohorts. Descriptive results demonstrate that maternal bereavement is increasingly patterned intergenerationally across cohorts, with most women experiencing the same fate as their mothers. Multivariable hazard models further show that, on average, women whose mothers were maternally bereaved have significantly increased odds of losing a child themselves. In most countries, the association is stable across cohorts; however, in select countries, the risk associated with having a bereaved mother is shrinking among more recent birth cohorts.

With Woman in Perinatal Loss

This paper explores how women experience perinatal loss, and how midwives can be supportive under these circumstances. It examines both the features of perinatal loss that unite women into a subculture of bereaved mothers, as well as some sociocultural issues, such as poverty, that can compound their grief. It also addresses the limited professional training that midwives receive in this area, and offers suggestions for how to better prepare them.

Rituals of Separation in the Face of the Death of a Child

Objective: To describe the separation rituals developed by bereaved mothers in the face of the death of their children. Methodology: Descriptive field research, with a qualitative approach, carried out in a municipality in the interior of Paraíba, with ten members of the “Mothers of Pieta” group, consisting of mothers who lost children of natural or tragic death and share their experiences with other mothers in the process. mourning. Data collection took place over two months, using the focus group technique through individual interviews. Results: Interpretations were obtained about the maternal experiences of loss produced from conceptual maps in the light of the rituals of "Before death" - the rite of anointing the sick or the hospital experience, "Before the burial" - rite of the funeral and " After the burial” – celebration of the mass in faithful memory of the deceased. Conclusion: It was found that each ritual has its relevance in the face of the displeasure caused in a situation of loss, which shows the loss can have a better understanding when symbols (rites) are adopted that help in the elaboration of this experience.

“We are in the Battlefield”: "Bereaved Mothers and Widows: Navigating Multigenerational Conflicts.

Although the loss of a close family member affects the family relationship, most studies have focused on the coping of individuals with the loss and only a minority have examined the family system and the mutual influence of family members on their adjustment to loss. Less is known about the intergenerational relations in the context of loss. The aim of this article is to discusses conflicts in the relationships between Israeli widows and bereaved mothers after the death of their husband and son. Methods: Semi-structured in-depth interviews were conducted with two groups of participants: ten bereaved mothers and ten widows (from different bereaved families) whose sons or spouses died while serving in the Israeli military, the police, or the security forces. The data were analyzed using thematic analysis. Results: The following conflictual issues were identified: (1) Fighting over the memory of the deceased; (2) Tensions around the relationship with the children/grandchildren; and (3) Offensive communication patterns. Discussion: These conflicts are discussed in the Israeli context. The grieving rituals and the honor bestowed upon soldiers and other members of the security forces and their families have paradoxically served to silence the issue. At the same time, the findings and the literature suggest an urgent need for professional intervention to help the families avoid disconnection, aggression and even violence in those vulnerable relationships and maintain them after the loss.

Healthcare professionals' needs when providing perinatal bereavement care: A qualitative study.

Caring for and supporting bereaved parents with fetal loss requires preparation, training, and attention to a set of needs of health workers to provide optimal services. This is although it has been less addressed in the educational curriculum and in-service training. This study aims to investigate the experiences of Iranian healthcare professionals regarding the needs related to the care of bereaved parents with perinatal loss. This research was a qualitative study conducted in Shahroud City, Iran, to explore healthcare professionals' needs from June 2021 to December 2022. Semi-structured in-depth interviews on purposive sample of 14 participants were conducted. The participants were care providers who worked in OB-GYN ward, general midwifery clinics, and a private office. The interviews were recorded verbatim, transcribed, and analyzed using an inductive content analysis. MAXQDA software version 10 was used for data analysis. Granheim and Lundman's approach was used to analyze the data. Two major themes, four categories, and nine subcategories emerged. The themes included the "existence of protective laws and policies" and "skill and training needs." Protective laws and policies included "Government Rules and guidelines" and "organizational Rules protecting the individual." Skills and training needs consisted of two categories: "communication skills" and "Self-Care needs." Educational policies, development of guidelines for the care of bereaved mothers based on culture, training programs for dealing with bereaved parents, providing self-care programs for employees, and improving the physical and emotional conditions of the workplace were among the needs expressed by the participants. Meeting the needs of healthcare professionals is effective in job satisfaction, feeling of value, and high quality of services for bereaved parents.

The Benefits and Burdens of Participation in Qualitative Research to Bereaved Mothers of Children Who Died of Cancer

The Benefits and Burdens of Participation in Qualitative Research to Bereaved Mothers of Children Who Died of Cancer

A midwife's reflective writing in lactation and grief

Midwifery is not just about life and joy; unfortunately, at times it also involves death, sorrow and grief. The death of a baby and subsequent grief is complex, and involves grieving the baby's life as well as the life that parents have imagined with their child, including their role as parents. Pregnancy and baby loss have devastating effects on women and their families; expecting life and meeting death leave a profound emptiness. Perinatal death can include miscarriage, stillbirth and neonatal death. Lactation in these circumstances has been described by bereaved mothers as a healing therapy, and although there is some published evidence on this topic, further research will be necessary. This article was written based on the author's personal and professional experience, combined with current evidence, following Gibbs' reflective cycle, which provides a structured approach to learning from experiences. The aim is to create awareness of the importance of giving women the opportunity to decide how to manage their lactation and to speak about a topic that, unfortunately, is still taboo.

Associations between parental depression, communication, and self-worth of siblings bereaved by cancer.

A child's death from cancer may increase the risk for poor self-worth in bereaved siblings. Furthermore, bereaved parents may experience depressive symptoms and communicate differently with their surviving children. However, limited research has examined family factors associated with self-worth in bereaved siblings. Thus, we examined: (a) differences in parental depressive symptoms, parent-child communication, and sibling self-worth between bereaved and nonbereaved families and (b) indirect effects of parental depressive symptoms and communication quality on the association between bereavement and sibling self-worth. Bereaved parents and siblings were recruited 3-12 months after a child's death from cancer. Bereaved (n = 72) and nonbereaved families of classmates (n = 58) completed home-based questionnaires upon enrollment (T1), and 48 bereaved and 45 nonbereaved families completed 1-year follow-up (T2). Relative to controls at T1 and T2, bereaved mothers, but not fathers, reported more depressive symptoms. Bereaved siblings reported poorer maternal and similar paternal communication, and similar levels of self-worth compared to controls. Both cross-sectional and longitudinal serial mediation models for mothers were significant. Bereaved mothers were at greater risk for depressive symptoms, which adversely affected sibling self-worth over time through disrupted mother-child communication. The father sample was limited, but the cross-sectional model was nonsignificant. Mothers and fathers may grieve differently and may require different therapeutic approaches. Family-centered interventions should target bereaved mothers' emotional adjustment and communication to enhance sibling self-worth. Additionally, clinicians should bolster other sources of support for bereaved siblings to promote adaptive outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

An exploration of women’s lived experiences of care and support following perinatal death in South-Western Nigeria: A hermeneutic phenomenological study

BackgroundPerinatal death results in long-lasting intense grief for bereaved mothers with a potential to negatively impact on their short- and long-term outcomes and quality of life if inadequately supported in coping with and managing their experience. AimThis study aimed at exploring the lived experience of women, of care and support following perinatal death in South-Western, Nigeria. MethodsA qualitative methodology using Heideggerian phenomenology was used. Fourteen women who had experienced perinatal death in South-Western Nigeria within the last (5) five years were interviewed, and Van Manen’s approach to hermeneutic phenomenology was used in data analysis. FindingsFour main themes were identified: “they did not tell me the baby died”, “response of health care professionals after the baby died”, “moving on from hospital”, and “support from family”. The physical health status of mothers determined how they were informed of perinatal death. Health care professionals were distant, rude, nonempathetic and did not offer emotional support, in some cases. Mothers were given opportunity to see and hold their babies. There was no routine follow-up support in the community, besides a postnatal check-up appointment offered to all mothers regardless of their birth outcome. Family provided emotional support for mothers on discharge. ConclusionThis study was the first to explore the lived experience of women of the care and support following perinatal death in South-Western, Nigeria. There is a need for healthcare systems to review bereavement care and support provisions for women who experience perinatal death.

Psychological profile of mothers who lost children due to violence

Grief is an amalgamation of symptoms and reactions related to significant loss. When a mother loses a child also loses its forecasts, projections, and idealizations. This study aims to psychologically analyze a sample of mothers who have lost children through violent means. They participated in ten mothers a town in Paraíba, selected through non-probability sampling for convenience. We used a socio-demographic questionnaire for the characterization data of mothers and Beck scales (Inventory Beck Depression, the Beck Anxiety and Beck Hopelessness Scale) and factorial scale of emotional adjustment / neuroticism to measure characteristics anxiety, depression, hopelessness, and emotional maladjustment. The results indicated a significant association between the variables vulnerability, anxiety, depression, inadequacy, and loss of time. The mothers had a higher incidence of anxiety symptoms. This study may contribute to the planning of a better continuous counseling the bereaved mothers.

Continuing bonds of bereaved Muslims mothers with their young dead child

Based on continuing bonds theory, this research examined the experience and manifestations of continuing bonds of bereaved Muslim mothers with their children who died in home accidents. This qualitative phenomenological study is based on interviews with 15 bereaved mothers (aged 28–46 years) whose children (aged 1–6 years) died 2–7 years before the interviews. Analysis revealed three themes: efforts to continue the physical bonds, challenges in the continuing bonds in cases of traumatic death, and belief in afterlife as the main element of the continuing bonds. The traumatic circumstances of the death challenged the ability to maintain the bond based on positive memories without it being overwhelmed by the traumatic memories of the last moments of the child’s life. Religious beliefs played an important role in the characteristics of the bond. Maintaining the bond requires professionals to provide a therapeutic environment where bereaved mothers feel safe talking about it.

A Mother's Voice: The Construction of Maternal Identity Following Perinatal Loss.

Maternal identity, a mother's internalized view of self as mother, has not been studied in relation to perinatal loss. This study aimed to investigate how women construct a sense of maternal identity after the loss of a baby. We interviewed 10 mothers who had experienced perinatal loss. A Listening Guide framework for narrative analysis was used to identify patterns of giving voice to the mother's own story. We identified 12 overarching voices which fell within three distinct groupings: voices of motherhood, voices of grief, and voices of growth. Although bereaved mothers grappled with constructing their maternal identity, they also demonstrated how maternal identity is individually and intuitively created through an honouring and remembering of the child that was lost, resulting in significant growth. There is need for a broader definition of what constitutes motherhood to encapsulate diverse mothering experiences, including perinatal loss.

Bereaved mothers’ media coverage and public support for harm reduction in Canada

Background Mothers whose child’s death is related to substance use have emerged as prominent and outspoken critics of Canadian drug policy in the news media. We examined the extent to which, and who among, the general public has seen or heard mothers bereaved by substance use in the media; predicted factors associated with exposure to such media; and explored associations with public acceptance of harm reduction. Methods We analyzed data from a 2018 online panel survey assessing Canadian views on harm reduction, using randomly-drawn provincially representative (N = 4645) and nationally representative (n = 2002) samples of adults. Results A majority (58.3%) of Canadians had seen or heard media featuring a mother whose child had died from an overdose. Respondents who had an increased level of familiarity with people who use drugs as well as older respondents were significantly more likely to have reported exposure to bereaved mothers’ media. Respondents who had been exposed to bereaved mothers’ media coverage were less likely to respond ‘don’t know/no opinion’ of harm reduction vs. opposing harm reduction. Conclusion Additional studies using a variety of methods are required to further evaluate the advocacy work being undertaken by mothers bereaved by substance use.

Innovation in Bereavement Care: Research Circles as a Framework for Translation of Research-Based Knowledge.

This article aims to contribute to the research-practice gap in bereavement care by exploring Research Circles as a collaborative approach to implementation of research-based knowledge into bereavement care. Particularly the article discusses key dimensions for translating research concerning bereaved after drug-related deaths into practice-relevant knowledge, as a first step of implementation. This co-created knowledge translation took place in the first phase of a Research Circle including bereaved mothers, practitioners and researchers. Data were collected via semi-structured interviews with Research Circle participants and field notes. Data were analyzed using reflexive thematic analysis. Results showed two key dimensions with the Research Circle approach influencing the translation process: (1) multiple and long-lasting arenas for translation: (2) multiple stakeholders and perspectives. Research Circles appear to be a promising framework for translating research-based knowledge in bereavement care, but there are some barriers to fully realizing the democratic ideal that underlines the Research Circle framework.

The Process Model of Stigmatized Loss: Identity-Threatened Experiences of Bereaved Mothers.

Despite almost one-third of women suffering from the loss of a baby through miscarriage, stillbirth, or infant loss, it is surprising how little research examines how such loss affects the identity and stigmas experienced by these individuals. Through in-depth, semi-structured interviews with bereaved mothers (in particular, mothers who lost a baby during pregnancy or within one year after birth), this research sheds light on the bereaved mother's experiences after loss. Specifically, this research applies the identity-threat model of stigma to showcase the process of stigmatized loss. Based on our findings, we also introduce the process model of stigmatized loss that can apply to all types of stigmatized loss. Key themes emerged as we explored stigmatized loss discourses. These include situational cues that trigger stigma, identity-based responses that aim to preserve both a baby's and mother's identity, as well as nonvolitional and volitional responses that help restore control and reconstruct identity. Additionally, other themes revolve around positive and negative outcomes stemming from avoiding stigmatized identity activation and identification of triggers that initiate a recursive process through stigmatized baby loss. Importantly, stigma can be perceived as both an identity threat (negative) and an identity confirmation (positive). Findings inform theory and practice alike.

Midwives Perceptions on Perinatal Loss Care of Bereaved Mothers at KweKwe General Hospital, Zimbabwe

Painful, distressful and discomforting is the caring for women who have experienced perinatal loss and may be very challenging for bereaved women and the midwife as well. This requires a nurturing as well as a professional approach and facets that ate mainly experienced than taught and learnt. Commonly, the area remained unresearched through the delicate intonations it bears and the sacrosanct perceptions surrounding death and loss of life and sacredness the subject. An in-depth qualitative phenomenological study explored the midwives’ perceptions on perinatal loss care of the bereaved mothers. In-depth interviews were used to gather data from a sample of 10 participants who were selected among midwives at Kwekwe maternity unit using purposive sampling. The sample was determined by the data saturation point and the inclusion criteria was of those who had worked at the unit for at least 6 months. Thematic analysis was used to analyze the data which gave rise to identification of themes. The findings revealed four emergent themes; knowledge and skills on bereavement care, psychological and emotional support, constraints to offering bereavement care and improving perinatal loss care. Midwives lacked requisite skills and knowledge to care for bereaved mothers, they void of care to bereaved mothers, inadequate psychological and emotional support from the family and midwives was of concern. Constraints were identified as shortage of staff, time, lack of continuity of care and inadequate infrastructure. Recommendations were training of midwives on management of mothers who would have experienced perinatal loss, counselling, improving infrastructure for confidentiality and proper management of the bereaved mothers and probable co-option of the conceptual framework developed in this study. Further research should focus on exploring the views of the mothers themselves since they are the custodians of the perinatal loss.

Women's experiences of care after stillbirth and obstetric fistula: A phenomenological study in Kenya.

Stillbirth and (obstetric) fistula are traumatic life events, commonly experienced together following an obstructed labour in low- and middle-income countries with limited access to maternity care. Few studies have explored women's experiences of the combined trauma of stillbirth and fistula. To explore the lived experiences of women following stillbirth and fistula. Qualitative, guided by Heideggerian phenomenology. Twenty women who had experienced a stillbirth were interviewed while attending a specialist Hospital fistula service in urban Kenya. Data were analysed following Van Manen's reflexive approach. Three main themes summarised participants' experiences: 'Treated like an alien' reflected the isolation and stigma felt by women. The additive and multiplying impacts of stillbirth and fistula and the ways in which women coped with their situations were summarised in 'Shattered dreams'. The impact of beliefs and practices of women and those around them were encapsulated in 'It was not written on my forehead'. The distress women experienced following the death of a baby was intensified by the development of a fistula. Health professionals lacked an understanding of the pathophysiology and identification of fistula and its association with stillbirth. Women were isolated as they were stigmatised and blamed for both conditions. Difficulty accessing follow-up care meant that women suffered for long periods while living with a constant reminder of their baby's death. Cultural beliefs, faith and family support affected women's resilience, mental health and recovery. Specialist services, staff training and inclusive policies are needed to improve knowledge and awareness and enhance women's experiences. A Community Engagement and Involvement group of bereaved mothers with lived experience of stillbirth and neonatal death assisted with the review of the study protocol, participant-facing materials and confirmation of findings.

“The Health Caregivers Did Not Care about Me after the Loss”: Maternal Experiences of Perinatal Loss in the Kumasi Metropolitan Area, Ghana

One of the common undesirable outcomes of pregnancy is perinatal loss. Healthcare systems strive to reduce the incidence of perinatal loss but typically little attention is on the experiences of bereaved mothers following perinatal loss, particularly in low and middle-income countries where such deaths are common. This research explored the lived experiences of mothers with perinatal loss in the Kumasi metropolis, Ghana. A qualitative design was used to explore the experiences of nine (9) bereaved mothers from the Komfo Anokye Teaching Hospital’s postnatal ward and the Mother and Baby Unit. Data were collected through face-to-face interviews using a semi-structured interview guide, audio-recorded, and thematically analyzed. One major finding was that mothers restricted mourning their dead babies based on fear of recurrent perinatal loss and traditional beliefs on delayed return to fertility. Mothers blamed healthcare providers for their loss due to their concerns about care received. Gaps in communication flow from healthcare professionals to bereaved mothers were commonly identified as mothers struggled to make meaning of their loss and coped with cultural restrictions and beliefs. Healthcare professionals must explore mothers’ concerns and “gut-feelings,” and pay attention to their communication needs following perinatal loss.