Pregnancy after perinatal loss: A meta-ethnography from a women's perspective

Abstract

Objective: This study uses a meta-ethnography to synthesize qualitative research on the experiences of women during pregnancies after one or more perinatal losses.

Design: This interpretive meta-ethnography followed the Noblit and Hare approach and the eMERGe Meta-ethnography Reporting Guidance. Manual searches and a comprehensive systematic search were conducted in Pubmed, Scopus, Cinahl, Web of Science, and Psycinfo. Eleven studies met the research objective and inclusion criteria.

Results: After reciprocal and refutational translations, the metaphor "The rainbow in the storm" and the following three themes emerged: (i) Between ambivalent feelings; (ii) being careful in the new pregnancy; and (iii) leaning on others. CERQual assessment showed that the results are (highly) reasonable representations of the phenomenon of interest.

Conclusions: Most women experienced their subsequent pregnancy with ambivalent feelings and needed to reduce expectations, continuously monitor the pregnancy's viability, and eliminate risky behavior to protect themselves. Understanding and recognition by others is needed and appreciated.

Implications for practice: Nurses and midwives play a crucial role in subsequent pregnancies and need to establish a care communion and ethical care during their encounters with affected women whose specific needs need to be incorporated into the guidelines and training curricula of care professionals to equip them with the necessary gender and cultural competences.

Keywords: Midwifery; Nursing; “Miscarriage”; “Neonatal loss”; “Pregnant woman”; “Qualitative research”; “Stillbirth”.