Temporal Themes in Periviable Birth: A Qualitative Analysis of Patient Experiences
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Temporal Themes in Periviable Birth: A Qualitative Analysis of Patient Experiences Tara A. Lynch1 · Melissa Cheyney2 · Meredith Chan1 · Jennifer Walia1 · Paul Burcher3
© Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Objective Periviable birth accounts for a very small percentage of preterm deliveries but a large proportion of perinatal and neonatal morbidity. Understanding parental experiences during and after periviable deliveries may help healthcare providers determine how to best support women during these medically complex, emotionally charged clinical encounters. Methods This is a qualitative study with a voluntary sample of women who delivered between 22 and 25 weeks gestation at an academic medical center from 2014 to 2016. Women’s narratives of each periviable birth experience were transcribed and analyzed using consensus coding and a grounded theory approach to identify key themes that describe parental experiences. Results A total of 10 women were interviewed. Four emergent temporal themes: (1) the time preceding admission: feeling dismissed; (2) transfer or admission to a tertiary care center: anxiety and doubt; (3) the birth itself: fear of the outcome; and (4) the postpartum period: reflection and communication. Conclusions for practice Women that experience a periviable birth may benefit from continuous support and clear communication. Overall, care for these patients should be expanded to address the specific psychosocial needs identified during the distinctive, periviable temporal themes that emerged during interviews. Continuous longitudinal support in the form of a designated person or team should be provided to women experiencing a potential periviable birth in order to help mitigate the fear and anxiety associated with these complex birth experiences. Keywords Communication · Periviable birth · Parental experiences · Temporal themes
Significance What is already known Studies in the NICU have demonstrated that families making end-of-life decisions following a premature birth have significant emotional and psychological consequences from these difficult choices. Other studies specific to preterm birth have demonstrated the importance of information provision and support. As periviable preterm Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10995-018-02727-8) contains supplementary material, which is available to authorized users. * Tara A. Lynch [email protected] 1
Department of Obstetrics and Gynecology, Albany Medical Center, Albany, NY, USA
2
Department of Anthropology, Oregon State University, Corvalis, OR, USA
3
Department of Bioethics and Obstetrics and Gynecology, Albany Medical Center, Albany, NY, USA
birth is extremely complex, a comprehensive understanding of this unique birth experience can further enhance provider counseling and support of these women and their families. What this study adds Women move through a series of temporal experiences, each with unique psychosocial ne
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