Experiences and perceptions of midwives and doctors when caring for mothers with pregnancy loss in a Gauteng hospital

Abstract

The purpose of this study was to explore and describe the experience of midwives and doctors when caring for mothers with pregnancy loss. To realise this goal, the researcher followed a qualitative, exploratory, descriptive and contextual approach. A purposive sampling method was used to select the doctors and midwives, using set criteria. Data was collected by using focused, semi- structured, individual interviews, taped and transcribed verbatim. Open coding combined with conceptualisation were used to analyse data until saturation occurred. Seven doctors and nine midwives who were interviewed described their experiences and perceptions when working with mothers with pregnancy loss. It became clear that both midwives and doctors lack the know-how to support mothers with pregnancy loss, and that they are overwhelmed by problems like shortage of staff and overcrowding. It is recommended that further research be conducted in other public hospitals, i.e. on a larger scale, to see if the findings are the same. It is also recommended that a counselling programme be developed to help health professionals deal with problems in the ward situation, while they are still able to attend to the mothers. The institution should develop guidelines, policies and procedures to help health professionals to cope when a life can no longer be saved. A multidisciplinary approach and conferences that target causes of perinatal loss are also recommended.

Opsomming
Die doel van die studie was om die ondervindinge van vroedvroue en dokters te ondersoek terwyl hulle vir moeders sorg wat ‘n miskraam gehad het. Om hierdie doelwit te bereik het die navorser ‘n kwalitatiewe, verkennende, beskrywende en kontekstuele ontwerp gebruik. ‘n Beskikbaarheidsteekproefmetode is gebruik om dokters en vroedvroue volgens vasgestelde kriteria te selekteer. Data is versamel deur gebruik te maak van gefokusde, semigestrukteerde, individuele onderhoude wat opgeneem en later getranskribeer is. Die data is ontleed deur oop kodering en konseptualisering te gebruik totdat versadigingspunt bereik is. Die sewe dokters en nege vroedvroue wat onderhoude toegestaan het, het hulle ondervindinge en persepsies beskryf tydens hulle werk met moeders wat miskrame gehad het. Dit was uit die resultate duidelik dat beide vroedvroue en dokters die kennis en ervaring ontbreek om moeders die nodige emosionele ondersteuning te gee. Probleme soos personeeltekorte en ’n oorvol saal is vir hulle oorweldigend. Daar word aanbeveel dat verdere navorsing op ‘n groter skaal in publieke hospitale uitgevoer word, ten einde te bepaal of die bevindinge dieselfde resultate sal oplewer. Daar word ook aanbeveel dat ’n beradingsprogram ontwikkel word om gesondheidsprofessionele te help om probleme in die saal te hanteer terwyl die moeders nog versorg word. Die hospitale moet riglyne, beleide en prosedures ontwikkel sodat gesondheidsprofessionele gevalle kan hanteer waar hulle nie die baba se lewe kan red nie. Multidisiplinêre benaderings en konferensies moet gereël word om die oorsake van perinatale verlies te bespreek.