RESEARCH

THE EXPERIENCES OF MOTHERS WHO LOST A BABY DURING PREGNANCY

Dr L Modiba
D Cur (RAU) Midwifery & Neonatology
D Cur Student, University of Johannesburg

Prof AGW Nolte

PhD
Professor, Department of Nursing Science, University of Johannesburg
Corresponding author: agwnolte@uj.ac.za

Keywords: loss of baby during pregnancy; miscarriage; neonatal death; stillbirths; experiences

ABSTRACT

The purpose of this study was to explore and describe the experiences of mothers who lost a baby during pregnancy
and care given by doctors and midwives during this period. To realise this goal the researcher followed a qualitative,
exploratory, descriptive and contextual approach. Data were collected by using in-depth unstructured interviews. The
interviews were taped and transcribed verbatim. Data were analysed through open coding. Data were collected until
saturation had occurred. All mothers who were interviewed described their experiences of the loss of a baby during
pregnancy. Some shared the same experiences and others did not. In the findings of this research, it became clear
that mothers with the loss of a baby during pregnancy had experienced hardships and difficult times during this
period. They expressed the wish that people acknowledge their loss, be considerate, sensitive, and give them a
listening ear and emotional support. On the other hand, mothers identified the inability of health workers to give
them the appropriate support.

OPSOMMING

Die doel van die studie was om die ervaring van moeders met betrekking tot die dood van ‘n baba tydens swangerskap
te verken en te beskryf, asook die versorging wat hulle van vroedvroue en dokters gedurende die periode ontvang
het. Die doel is bereik deur ‘n kwalitatiewe, verkennende, beskrywende en kontekstuele ontwerp te volg. Data is
ingesamel deur middel van in-diepte onderhoude. Die onderhoude is op band opgeneem en verbatim getranskribeer.
Data is deur middel van oop kodering geanaliseer. Data is versamel totdat versadiging bereik is. Al die moeders
met wie onderhoude gevoer is het hulle ervarings van die verlies tydens swangerskap beskryf. Sommige het dieselfde
ervarings gehad en ander nie. Dit was duidelik in die bevindinge van die navorsing dat moeders wat die verlies
tydens swangerskap beleef het, moeilike tye beleef het, en daarom gewens het dat mense begrip vir hulle verlies
sou hê en ook konsidererend en sensitief sou wees, na hulle sou luister en aan hulle emosionele ondersteuning sou
gee. Hierteenoor het moeders die onvermoë van gesondheidswerkers om die ondersteuning te gee geidentifiseer.

HEALTH SA GESONDHEID Vol.12 No.2 - 2007 3

INTRODUCTION AND BACKGROUND The death of an infant is often considered “an unfortu-
nate occurrence”, and one that can easily be rectified
The loss of a baby during pregnancy can take numer- by the birth of another child. Often, no one but immedi-
ous forms, given individual circumstances. These could ate family members see the baby. Because of this, to
be a miscarriage, an ectopic pregnancy, or a stillbirth, most people, the baby did not exist as a “real person”
which means loss of an embryo or a fetus. The loss of and they cannot begin to be aware of the love, the hopes
a baby during pregnancy not only involves the catas- and the future that were lost with that child (Mander,
trophe of a baby’s death, but also shatters parents’ 1988:1).
dreams, plans and hopes. “Grief or mourning”, or be-
reavement, means to be robbed of something valued, According to Condon (1986:987), there are repeated
because that something, or someone, has been un- findings in the literature that approximately one third of
fairly taken away, it is understandable that the experi- parents bereaved by stillbirth perceive the obstetric team
ence of being bereaved is one of strong, overwhelming as failing to provide adequate support or information in
and sometimes even violent reactions (Baker & both the short and longer terms. These parents may
Nackerud, 1999:1). The loss of a baby during pregnancy be at greater risk of subsequent psychiatric illness.
holds great significance for the parents, the loss of an
adult is the loss of the past, and the loss of the baby is PROBLEM STATEMENT
the loss of the future. A baby can represent hope for
the future, hope of a better life, and hope of greater Although the general topic of death and dying is receiving
opportunities. A baby can represent the potential for increasing attention by the medical community, the
fulfilling the dreams, a way of starting over, another problem is that little is known about the impact that the
chance to alter the course of a lifetime. A baby can loss of a baby during pregnancy has on the lives of
embody dreams and fantasies. The child can become those experiencing it. What happens to these people
a part of the parent’s identity, and that part of the iden- after the woman is discharged from the hospital? How
tity is lost. It is no surprise that the loss of a baby do parents as individuals react to their loss? What
during pregnancy often results in increased anxiety in happens to a couple’s relationship with each other as
subsequent pregnancy and feelings of guilt. And this a result of their baby’s death? (Kennel & Klaus,
period is oftentimes a period of crisis. 1982:267).

One must be careful, however, to avoid making assump- In Kennel and Klaus (1982:264), it is stated that there
tions about the meaning of the loss of a baby during is a wide range of reactions of people in response to
pregnancy to a particular woman. It is difficult, if not the loss of a baby during pregnancy. Its potential effects
impossible, for anybody else to understand the signifi- can alter the lives of those who experience it. The grief
cance of a pregnancy or a baby to another person. each person feels is a unique part of them. Therefore,
This is because the loss of a baby during pregnancy no one else can completely understand another’s pain.
carries with it a vast range of profoundly deep feelings, Thus, it is important to describe and explore the
which include unspoken hopes and expectations based experiences of every mother who experiences the loss
on personal as well as cultural values. Attempts have of a baby during pregnancy.
been made to compare the severity of grief following
loss at different stages, perhaps to demonstrate that In practice the researcher experienced that there are
certain women deserve more sympathy or care. A study many complaints from bereaved mothers about the lack
investigating this point, however, showed no significant of support given to them during their grieving process.
differences in the grief response between mothers los- The mothers verbalise that all the doctors and midwives
ing a baby by miscarriage, stillbirth or neonatal death seem to care about is that the baby has been delivered,
(Frazer & Cooper, 2003:696). after which they apparently do not care about the
emotional trauma the mother is undergoing. The
Those who have lost newborns or who have experienced strongest reactions probably occur when there are
stillbirths have found that people do not recognise the comments suggesting that the family should forget
loss as being as tragic as the loss of an older child. about the loss and get on with their lives or get on with

4 HEALTH SA GESONDHEID Vol.12 No.2 - 2007

another pregnancy. It may be even suggested that the personally involved in an event, a situation or a circum-
baby was small and therefore their loss should not be stance (Burns & Grove, 2003:15).
as great as it would have been if the baby had lived
longer (Kennel & Klaus, 1982:267). RESEARCH DESIGN AND METHOD

From the above-mentioned problem statement the fol- In this research, a qualitative research design, which is
lowing questions arose: exploratory, descriptive and contextual in nature
• How did the mothers experience the loss of a (Mouton, 1996:169; Mouton & Marais, 1990:45), was
baby during pregnancy? used.
• How did the mothers experience care given by
midwives and doctors during the loss of a baby Understanding the meaning of a phenomenon in a par-
during pregnancy? ticular situation is, useful for understanding similar phe-
nomena in similar situations (Burns & Grove, 2003:37-
PURPOSE OF THE RESEARCH 38; Mouton, 1996:133; Mouton & Marais, 1990:52). The
strategy of this research is contextual in nature (Mou-
The overall objective of this research was to describe ton, 1996:133; Mouton & Marais, 1990:52). The research
the experiences of mothers with the loss of a baby thus aims to provide a description and an exploration
during pregnancy and the professional care they re- of a particular phenomenon or experience or group,
ceived during this period in the maternity unit of a pub- within the context of the phenomenon’s specific set-
lic hospital in Gauteng Province, South Africa. ting and world significance.

DEFINITIONS OF TERMS This research focused on how mothers experienced

the loss of a baby during pregnancy and the care given
Concepts used in this study are defined as follows: by midwives and doctors in a public hospital in Gauteng.
Their viewpoints will be based on knowledge obtained
The loss of a baby during pregnancy: This is when through the field study.
a mother looses an embryo/fetus during pregnancy due
to a miscarriage, an ectopic pregnancy, or a stillbirth DATA COLLECTION
(Woods & Esposito, 1987:120).
In-depth unstructured interviews were conducted with
Bereavement: Bereavement is defined as the entire mothers who lost a baby during pregnancy. These in-
process precipitated by loss through death. In this re- terviews were taped and transcribed verbatim in the lan-
search the bereaved are mothers who have lost a preg- guage preferred by the mother. The interviews were held
nancy (Woods & Esposito, 1987:5). within the first six weeks after the diagnosis had been
made. The time depended on the emotional condition
Support: In this study, support is that function that of the mother because immediately after delivery, some
prevents or reduces stress in a mother with the loss of mothers were too emotional to discuss or describe their
a baby during pregnancy. Supporting her makes her loss. Therefore interviews were scheduled from forty-
feel accepted and respected. She is reassured that eight hours to six weeks after delivery for those who
she is cared for and is allowed to communicate freely were not ready for the interview when they were still in
and share her experiences and feelings. The support hospital.
should be given initially by health workers, and later in
co-operation with family and other community mem- One question was asked, namely: “Describe how you
bers, for example, the church. experienced the loss of your baby during pregnancy
and the care you received from both midwives and doc-
Miscarriage: Spontaneous loss of pregnancy before tors during this period”. During the interview communi-
viability (Frazer & Cooper, 2003:1034). cation skills were used to obtain the necessary infor-
mation.
Experience: It involves gaining knowledge by being

HEALTH SA GESONDHEID Vol.12 No.2 - 2007 5

The researcher contacted each participant to confirm lost their babies during pregnancy and who were ad-
an appointment at a central place and at an appropriate mitted to the maternity unit were interviewed. Patton
time for the participants. Comments were made about (in Denzin & Lincoln, 1994:229) suggests that the logic
sensitive ethical issues such as maintaining and power behind purposive selection should be infor-
confidentiality of data, preserving the anonymity of the mation-rich. In this research the adequacy of the re-
informants and using research for its intend purposes search was attained when sufficient data had been
(Creswell, 1994:148). The ethical standards as set by collected so that saturation occurs and variation is both
the Democratic Nursing Organisation of South Africa accounted for and understood (Denzin & Lincoln,
(DENOSA) were adhered to before and during the 1994:230). Saturation means that themes and catego-
interview (DENOSA, 1998:1-7). ries in the data become repetitive and redundant, such
that no new information can be gleaned by further data
The researcher created a context that was conducive collection (Polit & Hungler, 1999:43). Ten mothers were
for mutual trust between the researcher and the sampled when saturation was achieved.
participant (Marshall & Rossman, 1995:67). Privacy was
ensured during the interview. The participants were DATA ANALYSIS
ensured that their participation was entirely voluntarily
and they could withdraw from the research at any stage “The intent of the analysis was to organise the data
if they felt so. The interviews would be stopped if the into a meaningful, individualized interpretation or frame-
participant suffered severe stress during the interview. work that describes the phenomenon studied” (Burns
The possibility of referring the participants for councelling & Grove, 2003:29). Tape recordings of the interviews
was discussed with them after the interview. were transcribed verbatim in the language in which the
interviews were held. Transcriptions were analysed by
A pilot study was conducted with one mother to refine the researcher according to Tesch (unmodified) (in
the question (Burns & Grove, 2003:38). The question Creswell, 1994) and by an independent coder. The per-
was asked to one mother and the interview was con- son was requested to also analyse the data according
ducted as planned. The reason was to see whether the to Tesch’s method, independently from the researcher.
question was clear to the mother and whether the in- The two analyses were then compared to ensure trust-
terview developed as planned. The mother understood worthiness. She was selected as she has obtained her
the question and the interview went well, so no changes DCur (Nursing), with a thesis in which she also used
were made to the question and interview procedure. qualitative interview methods. Data analysis is a pro-
This mother and interview was therefore added to the cess of bringing order to the data, organising what is
main sample. collected into concepts, categories and basic descrip-
tive statements (Patton, 1987:144).
POPULATION AND SAMPLING
Enhancing trustworthiness
Population
Trustworthiness refers to the extent to which a research
The population consisted of mothers who lost a baby study is worth paying attention to, worth taking note of,
at any stage during pregnancy and who were admitted and the extent to which others are convinced that the
to a maternity unit of a public hospital in Gauteng. It is findings are to be trusted (Babbie & Mouton, 2001:276).
mostly Black patients who are treated in this hospital. The criteria by Lincoln and Guba (1985:290-300) served
The research is bound to the uniqueness of this spe- as guidelines for the researcher.
cific academic public hospital in Gauteng and is not
representative of the whole population. To enhance credibility the researcher:
• had prolonged contact with the study field. She
Sampling is a midwife, who has knowledge and clinical
experience in this area. The literature that was
A purposive sampling method was used to select the consulted enabled her further to satisfy the
mothers, using set criteria, that is, all mothers who criterion of being knowledgeable about the phe-

6 HEALTH SA GESONDHEID Vol.12 No.2 - 2007

 nomenon under investigation; analysis and interpretation of the research findings, in
• bracketed existing knowledge and precon- a research report.
ceived ideas and especially personal views
about the existing problems in the clinical area; RESULTS
and
• conducted the phenomenological semi-struc- The results were based on the analysis of the in-depth,
tured interviews until data saturation occurred, unstructured interviews with mothers about how they
namely until the collected data were repeated experienced the loss of a baby during pregnancy and
and confirmation of previously collected data the care they received from doctors and midwives. After
took place (Streubert & Carpenter, 1995:22-23). a discussion with the independent coder all identified
themes and sub-categories were finalised. A literature
The categories identified by the researcher were com- control was integrated as a further measure of
pared with those identified by the other coder. No ma- trustworthiness of the findings (Lincoln & Guba, 1985:
jor discrepancies were identified between these per- 294-331).
sons’ analysis of the data. An in-depth literature review
further confirmed these categories. This enhanced All mothers who were interviewed described their ex-
confirmability. periences of the loss of a baby during pregnancy, some
shared the same experiences, but some did not. The
Transferability was ensured by the researcher provid- themes of experiences that were identified were:
ing in-depth discussions of the data obtained, data

Table 1: The experiences of mothers who lost a baby during pregnancy (N= 10)

Themes – The mother’s experience of the loss

• Confused (losing one’s mind)
• Emptiness (there is no fulfillment)
• Sadness (at losing the baby)
• Pain (emotional pain)
• Anger (towards oneself, baby, nurses and doctors)
• Guilt (that maybe she caused the death)
• Fear (of falling pregnant again)
• Denial (that she lost the baby)
• Failure (to fulfill expectations)
• Frustration (because of losing the baby)
• Loneliness (because of isolation)
• Lost hope (of falling pregnant again)
Themes – The experience of mothers regarding the care given by midwives and
doctors during the incident
• Lack of communication leading to lack of information
• Lack of therapeutic listening
• Lack of emotional support
• Insensitivity
• Health workers do not care about patients

HEALTH SA GESONDHEID Vol.12 No.2 - 2007 7

Confusion empty hands whilst other mothers were holding their
babies. “You know, I just felt confused. I could not cry,
Mothers experiencing the loss of a baby during preg- I really felt empty”. “When a child is born dead, there is
nancy have confused emotions and feel as if they are nothing. The world remembers nothing and the gap in
losing their minds. the womb is replaced by an emptiness in your arms.
You are not recording a birth or a death”.
The following excerpts from the interviews support this
discussion: “I really feel terrible. I feel confused and I Sadness
feel as if I am going to lose my head”. “Finally, I heard
my baby crying weakly. Nobody said anything, so I Mothers who have lost a baby before giving birth, feel
asked, ’Is it a boy or a girl?’ My doctor responded that sad because of this tragedy, and because of the emp-
there were problems and she could not tell. I was con- tiness and disappointment. “But I am glad that I held
fused, I must have heard wrong. I asked her again. him because I know that I was pregnant and it was not
She repeated the same answer with no other explana- just me dreaming. I am glad in that respect, but it’s
tion. No one showed me my baby”. very sad, because I know what he looked like and I
know he was gorgeous, and I think it’s unfair…”.
Chalmers (2000:16) states that what most people dread
after losing a baby is that their experiences may seem According to Borg and Lasker (1981:20), there is also
to be illogical or irrational. However, when bereaved an overwhelming sadness as is usual after any trag-
couples talk with other parents who have lost a baby, it edy. Some parents feel sad for the baby. They say that
soon becomes clear that “they are not going crazy”, it seems particularly unfair for a baby to die. It is ex-
but that the up-and-down and “confusion” feelings they pected that an elderly person, who has experienced
are experiencing are common reactions to pain and life, will die, but an infant is thought to deserve a chance
are to be expected. at life. They are sad for themselves as well, sad be-
cause of the emptiness and disappointment. Their wish
Borg and Lasker (1981:17) suggest that parents some- to become parents – to have someone to nurture, to
times think they are “going crazy”. Their emotional re- love, to teach, to care for, to play with – someone who
action is so strong that they become disoriented, de- would care for them in their old age and inherit the ben-
pressed, bitter and withdrawn for many months and efits of their work – has not been granted.
maybe even years. Friends may expect them to bounce
back quickly, have another child and try to forget the Pain
past, but they cannot forget. Borg and Lasker (1981:36)
further suggest that whatever the source of failure of Mothers say the pain they are feeling is not physical
others to express sympathy, it leaves couples feeling pain but emotional pain because in the end there is no
alone and confused about their emotions. Many people reward. The following excerpts confirm this: “At times
never speak about a miscarriage at all and have a very it is not easy to communicate the pain because there
difficult time resolving their grief. They may find it hard is simply no appropriate language with which to describe
to tell people who did not even know they were expect- the tragedy”. “It was painful and when I say painful I
ing, that the pregnancy had ended. Often, however, they don’t mean like a headache! But what can I say …
find comfort from talking to others who have themselves emotional pain”.
been through a miscarriage and who can understand
the sadness, the fears, the anger and the disappoint- When a baby is stillborn the hopes built up during the
ment. months of pregnancy are suddenly gone. It is not only
the mother who is affected. Fathers also develop an
Emptiness attachment to the baby before it is born. Some still-
births occur with foreknowledge of the situation and it
According to mothers who lost a baby during pregnancy, is known that the baby is already dead. This is very
there is no fulfillment of giving birth to a baby because painful for parents, especially if they have to wait for
there is no baby. They came back from hospital with the natural onset of labour to produce a dead baby

8 HEALTH SA GESONDHEID Vol.12 No.2 - 2007

(Wright, 1992:102). ings on care providers protects these family relation-
ships for more positive interactions (Mereinstein &
Anger Gardener, 1993:536).

The anger that these mothers experience is because Guilt

they have delivered a dead baby. To them there is no
reward. Sometimes they are angry with themselves, Most mothers experience feelings of guilt, because they
the baby, the nurses and the doctors. “The anger is think that perhaps they caused the death by doing some-
because you are going to deliver a foetus that is dead. thing wrong and sometimes because they failed the
I’m going to go through this pain and in the end there is child by not carrying her/him to term. The following
no reward. There is no baby. You come home empty. excerpts confirm this: “I felt myself it was my fault. I
Nothing … Life goes on”. “I needed people to acknowl- felt it was something wrong with me that makes my
edge what had happened, not to trivialise it. I was grate- babies be born early. I feel it’s my body rejecting the
ful for the people who listened, and stayed, knowing baby”. “I just don’t want to encourage anything to hap-
that they could not take away the hurt. I was angered pen. I think really I am blaming myself for going into
by those who tried to make it better, with false comfort labour, for getting out of bed. If only I had stayed in
and too quickly offered explanations …”. bed that extra day, would it have made any difference?”

In the study conducted by Cleirel (1991:256), it was Most parents (especially mothers) feel guilty that their
shown that “… anger after loss must be seen as an baby has died. They search the months of pregnancy
individually defined way of coping with the loss, rather trying to pin the cause for their child’s death on some-
than a “typical” part of the loss reaction. Feelings of thing they may have done. This is a normal reaction,
anger are often regarded as protest against the loss. It and healthy as long as they talk about it together, rather
has been found that it may be directed towards differ- than hiding these feelings from each other. It is only
ent people, objects or circumstances that may also be after they have gone through the long, slow process of
held responsible for the death”. checking possible causes that they will gradually come
to accept that they did not cause their baby’s death
Woods and Esposito (1987:138-139) explain that of- (Chalmers, 2000:12).
ten, behind the question “why?” is anger. This anger
has no focus. Parents are angry at everything and ev- Fear
eryone at the same time. They realise that no one and
nothing can be blamed. How frustrating this is. Some- Mothers experience fear falling pregnant again. They
times, parents are able to express anger at God. They fear that loss will happen again. “I still feel sad and I
ask, “Why, when there are so many people out there have fear of falling pregnant again”.
who mistreat children, does God allow them to have
babies, and yet he stops us from having this child we Meinstein and Gardener (1993:532) mention that, for
wanted so much?” the family who experiences an intrapartum demise, the
joyous expectations of labour and birth suddenly
Anger is the result of a gradually developing aware- changes to fear, anxiety and dread that the “worst” might
ness of the reality of the situation. As the significance possibly happen to them again.
of their loss of a baby during pregnancy begins to dawn
on them, parents (and significant others) experience Woods and Esposito (1987:252-253) stress that, if a
the different emotions of anxiety and anger. With the previous pregnancy has ended disastrously, a couple’s
full effect of their loss, come more focused feelings of anxiety and fears, both founded and unfounded, might
bitterness, resentment, blame, rage, and envy of those be greater than normal. Issues regarding perinatal di-
with normal pregnancy outcomes. Blame and anger agnostic testing need to be discussed. Pertinent infor-
may be a destructive force in relationships with family mation and the rationales in support of or against a
members, and prevent these relationships from being patient’s having amniocentesis or sonograms performed
a source of comfort and support. Venting of angry feel- need to be explored. Many parents, during a subse-

HEALTH SA GESONDHEID Vol.12 No.2 - 2007 9

quent pregnancy, opt for more testing than is probably The following excerpts confirm this: “Although I did not
necessary. The tests eliminate some of their anxiety. want others to suffer, I was angry, frustrated and de-
Indeed, maternal anxiety is a valid factor to be consid- pressed, and so I distanced myself”. “I felt bad, and
ered in determining what testing will be done, even if frustrated because when you carry the baby for so long,
the previous pregnancy would not have had a better you expect a sort of reward, that is, getting a live baby
outcome if a particular test had been carried out. … This is really frustrating”.

Denial When a tragedy occurs, a woman’s confidence is of-

ten shattered. The effort of becoming pregnant and plan-
After losing a pregnancy mothers attempt to deny the ning for a baby is too great, and she is determined
reality of the loss, because they do not want to face never to go through such a trauma again. For the woman
the pain of this loss. who very much wanted a child and can no longer look
forward to having one, there is a deep frustration in ad-
This is confirmed by the following excerpt: “After the dition to the grief for the baby who was so loved (Borg
miscarriage was over, I had this crazy feeling that I & Lasker, 1981:94).
would go home and continue with the pregnancy. I knew
the reality, but somehow I did not believe it”. Loneliness

Borg and Lasker (1981:19) explain that, although it is Mothers who have lost a baby in pregnancy often feel
essential that the bereaved parents express their emo- lonely and empty, and this feeling of loneliness inexpli-
tions over time and talk about their loss, some degree cable. “I though I was going crazy and ah, I hoped for
of denial is a normal part of grieving. It is a form of it, so the pain would stop. Because it just hurt so much
protection, a way of not having to face up to the pain. – the loneliness … just unbelievable loneliness. Ah,
“This did not happen to me” is a common feeling. it’s just like – the pain and the loneliness and having to
deal with it, ah! You just kind of wish you would slip
Failure over that edge into some unknown space and not have
to worry about it any more”.
A mother who loses a baby feels that she has failed to
fulfil the expectations of being a woman, a mother. She Borg and Lasker (1981:7-8) report that bereaved par-
feels she has failed herself, her husband and most of ents experience feelings of being alone and isolated
all her child. “I guess it’s important to carry on one way from others. Most of their family and friends do not un-
or the other. Think of new changes – focus in on some- derstand what sort of emotional support is needed. “At
thing else. There are a couple of courses that I wanted least you never knew this child”, they will say, hoping
to do, so I can think about a career change. In some to ease the pain or “it could have been worse” or “you’ll
way, I feel like a failure and wonder if my life plans are have another one”. In their own way, they might be try-
possible. So I think the main thing will be useful and ing to offer hope for the future, but to the bereaved par-
meaningful”. “I feel … you know, it is something I can- ents, it often seems that these people do not compre-
not describe, but I feel like a failure”. hend the enormity of what has happened.

It is common for parents especially the mother, to feel Lost hope

that they are a failure as people, and to be afraid of
facing people as failures (Borg & Lasker, 1981:148). Mothers lose hope because all their hopes and dreams
were lost through this tragedy. There is profound disap-
Frustration pointment and all plans collapse. “I felt empty because
I knew I was going to give birth to a dead baby, and I
Mothers with the loss of a baby during pregnancy be- lost hope”.
come frustrated because they could not achieve their
goal of delivering a live baby. One participant in Pilkington’s study (1993:134) said
she was feeling empty with shattered dreams and lost

10 HEALTH SA GESONDHEID Vol.12 No.2 - 2007

hope. The participant reached out to God for strength Lack of emotional support
and found an acceptance and a desire to pull through
one step at a time, while weighing her blessings and What mothers would like to see is midwives and doc-
finding ways to fill hollow feelings. tors giving them emotional support by comforting, talk-
ing and being there during this time.
FEEDBACK FROM THE MOTHERS WITH
THE LOSS OF A BABY DURING PREG- The following excerpt confirms this: “What I ask from
NANCY ON THE CARE GIVEN BY MID- the nurses is that they should try hard to comfort pa-
WIVES AND DOCTORS tients who come in. They should try hard to look at the
other person’s problem, try to comfort her the way they
Lack of communication that leads to lack have been taught, and according to their capability,
of information because most of the time, at home there is no time for
this”.
Mothers raised concerns about midwives and doctors
not communicating with them. Therefore, it would ap- Mereinstein and Gardener (1993:545-546) explain that
pear that these mothers are not given enough informa- professional presence and support are essential to fami-
tion, sometimes none at all. This in itself will lead to lies in crisis because of the increased dependency
them making uninformed decisions. “Even in the ante- needs that accompany grief and loss. Yet certain as-
natal ward, nurses don’t communicate with you”. “Doc- pects of the environment such as privacy, quiet and
tors don’t have time for the patients. Just a few. But comfort may be difficult to obtain in a noisy and busy
they don’t have time for the patients! Most of them don’t perinatal setting. The recommendation to never leave
have time for the patients. So, I thought maybe that the family alone must be balanced with their need for
once they talked to the nurse about the patient’s prob- privacy and personal time alone with their baby (that
lem or when they write in the bedletter, that means they is, stillborn, ill or dying). Simply saying, “I will stay with
leave it to the nurses”. you unless you ask me to leave so that you can have
some private time with your child” or “Would you like
Lack of therapeutic listening me to leave for a while so that you can be alone with
your baby?” offers both support and privacy.
Mothers stated that they wished that midwives and
doctors could give them a listening ear when they spoke Insensitivity
about their loss. They mentioned how frustrated they
were, because most of the time there was nobody to Most of the time midwives and doctors are insensitive
talk to and the stress built up. in the way they treat mothers and their stillborn ba-
bies. These mothers are screened in the labour ward
The following excerpt confirms this: “Because most of and they deliver without any person attending to them.
the time at home there is no time for this, when you Dead babies are not treated the same as those who
arrive at the hospital, you find women with their kids, are alive, and they are often wrapped in plastic or placed
happy, and you are sitting there with a painful heart, in in a receiver. “I wanted to be treated like others, but
tears. You miss a person who will sit next to you, and because he was dead, I could just deliver him on a
let you open up to her”. plastic”.

According to Mander (1999:1) if possible a sympathetic Woods and Esposito (1987:65-66) suggest that, at
listening ear is needed, but in the absence of a human delivery, care providers should balance the patients’
ear other means such as pen and paper, may allow the perception of events with technical aspects of the pro-
necessary outpouring to help her to make connections cedure. All too often, stillborn foetuses are delivered
between this experience and the other strands of her into a pan or in the labour bed. Although these ap-
life. proaches may satisfy clinical standards for a stillbirth
delivery, they can impart a very negative and uncaring
attitude to the patient.

HEALTH SA GESONDHEID Vol.12 No.2 - 2007 11

Health workers do not care about patients Better support for staff would help them to provide bet-
ter support for parents. Nursing guidelines should be
Mothers experienced a lack of care for them as pa- developed for quality care of these patients.
tients. It appeared to many of the mothers that, once
their doctors established that the baby was dead, they Nursing education
relinquished care to the nurses.
There is a need to educate nurses on the grieving proc-
The following excerpts confirm the discussion: “Doc- ess and specific interventions for bereavement care.
tors don’t have time for the patients. Just a few. But
they don’t have time for the patients! Most of them don’t CONCLUSION
have time for the patients. So, I thought maybe that
once they talked to the nurse about the patient’s prob- In the findings of this research, it became clear that
lem or when they write in the bed letter that means they mothers with the loss of a baby during pregnancy ex-
leave it to the nurses”. “The doctor avoided me, and perienced hardships and difficult times during this time.
when I pressured him, he said: ‘These things happen They wished that people acknowledged their loss, were
and you should try to put that behind you’. He really considerate, sensitive and gave them a listening ear
offered no support, he was so cold”. and emotional support. On the other hand mothers re-
flected the inability of health workers in giving them the
LIMITATIONS appropriate support. The health care providers should
keep in mind that every parent in this situation is on
One limitation was that the researcher did not always their own journey. Their job is to walk with the parents
gain the co-operation of the staff in the clinical area. As on their journey.
they failed to call the researcher when there was a
mother to be interviewed, some clients would leave with- LIST OF REFERENCES
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