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Women’s Experiences of Labour and Birth When Having a Termination of Pregnancy for Fetal Abnormality in the Second Trimester of Pregnancy

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Thesis(1.86 MB)

Date

2023

Authors

Supervisor

McAra-Couper, Judith
Fleming, Tania

Item type

Thesis

Degree name

Doctor of Philosophy

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Volume Title

Publisher

Auckland University of Technology

Abstract

This thesis calls attention to women having a termination of pregnancy for fetal abnormality by highlighting their lived experiences and the meanings they attribute to these experiences. Phenomenological material was gathered from four women using semi-structured interviews. A post-intentional phenomenological design was used, along with theoretical models of existential phenomenology and The Meaning-Centred Grief Model. The women's narratives lent themselves to the development of crafted stories that allowed for the uncovering of what had previously been hidden. Women felt a deep sense of being alone during their experience that represented more than a lack of physical 'thereness' of others. They realised that they were existentially alone giving birth to their babies, even when surrounded by people who cared for them. Through social stigma, being overwhelmed and devastated for making the decision to end their pregnancies, they felt silenced in their grief. A sense of unpreparedness left the women with feelings of uncertainty and not being ready for the reality of what was happening. The women shared a vulnerability that reflected a place of fear, shame, guilt and judgement from others. This place allowed for the possibility of holistic harm that for some of the women, they felt they deserved. Women desperately wanted connection, acknowledgement and compassionate support as they went through the loss of their babies. They needed time and breathing space to make sense of what was happening and come to terms with the reality. The findings of this work offered a deeper understanding of women's unspoken embodied experiences of ending their pregnancies. This insight supports health care providers to see each woman as unique in both her needs and her ways of finding meaning in the loss of her baby. It encourages the use of woman/family-centered bereavement care planning that reflects what is important to them in the context of a termination of pregnancy. These findings re-focuses care that allows the woman, her family and her caregivers to connect in a more intimate way that offers a sense of holistic safety, interrelatedness and of being on a shared journey. This work encourages caregivers to walk closely beside the women and their families to nurture this humanistic relationship and to bring a sense of togetherness. This work puts a spotlight on bereavement care and the need for it to be prioritized in maternity care provision. Midwifery education is needed, at both undergraduate and post graduate levels, that is consistent, contemporary and supportive of this level of care. Caregivers are encouraged to acknowledge the journey of women having a termination of pregnancy is a complex, entangled and context-driven experience that deserves the utmost consideration and attention. The findings reflect a body of evidence that acknowledges the devastating experience of terminating a pregnancy for fetal abnormality and prompts caregivers to approach this care with the woman and her family firmly at the center of the care.

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http://hdl.handle.net/10292/17793

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Doctoral Theses