A Comparison of the Caring Processes Used By Obstetric, Surgical, and Emergency Nurses When Caring for the Woman with a Fetal Loss

What's wrong with using the F word? A systematic integrative review of how the fetus is talked about in situations of fetal demise or high risk of fetal loss

BACKGROUND

Limited research exists that investigates the language parents and health professionals use when faced with a high-risk likelihood of fetal demise or an instance of fetal loss. This review examines the language used when referring to the 'fetus' in these cases to better understand the meaning different groups might ascribe to the fetus and how their word choice may reflect their strategies for managing in these situations.

METHODS

An integrative review of primary, peer-reviewed research was conducted. A systematic search of seven databases was undertaken, articles critiqued and summarised using the Preferred Reporting Items for Systemic Reviews and Meta-Analysis (PRISMA). The comprehensive process of data analysis and synthesis followed a constant comparison approach.

RESULTS

The 23 included studies represented the voices of women, their partners, obstetricians, nurses, midwives and allied health professionals. Five major themes emerged with the main finding being that the term 'Baby' is the most widely recognised word used in instances of fetal loss and high risk of fetal demise.

CONCLUSION

History, science and law all influence how the fetus is understood and discussed within society. This review contributes new insights into our understanding of the term 'fetus' emphasizing the need for further research into the way the fetus is addressed and dealt with in instances of fetal loss or high risk of fetal loss within Maternity care practices.

Creation of interdisciplinary guidelines for care of women presenting to the emergency department with pregnancy loss

A research trajectory is reported that created state-of-the-art interdisciplinary guidelines for care of women and their families who arrive in the emergency department with pregnancy loss. These guidelines include attention to mother and family bereavement as well as care of the fetus. Design was a triangulated non-experimental exploratory action research for the purpose of changing practice. Included were: (1) A qualitative study of emergency room nurses and physicians to assess beliefs/barriers to providing optimal care for pregnancy loss patients. (2) A focus group of perinatal bereavement providers; (3) Another focus group in the form of a sponsored National Summit of professional and lay experts and (4) A Delphi Study to craft language for national position statement. Results allowed the creation of interdisciplinary guidelines from the National Perinatal Association. These guidelines are being adopted by organizations and facilities throughout the United States. Training programs for emergency department personnel have been created by pregnancy loss organizations and are available.