Program

Nurse-Midwifery M.S.

Number of Pages

48

Year Approved

2023

First Advisor

Hardy, Paige

Second Reader

Julie Ann Vingers

Abstract

Perinatal loss due to fetal congenital anomalies places parents at high risk for complex grief. Perinatal palliative care is a holistic option that may decrease complex grief yet is under-utilized in midwifery practice in the United States. Purpose: To examine: (a) the impact of perinatal palliative care (PPC) on parental grief, and (b) how PPC can be integrated into holistic midwifery practice. A keyword search of the literature from 2011–2023 was conducted from the following databases: CINAHL, SCOPUS, ScienceDirect, PubMed, and Google Scholar. The search yielded 22 original studies that met the exclusion and inclusion criteria defined by the authors of this paper. Study findings and demographics were extracted from the literature and classified according to Worden’s theory of the four tasks of grieving. Lived experiences of 1,277 parents demonstrate complex grief occurring at the time of diagnosis due to the emotional attachment already formed to the baby. Throughout pregnancy and birth, parents valued consistent, empathetic health care providers and particularly valued care from midwives. Findings revealed parents’ benefits from PPC include: (a) affirming their identity as parents and the baby’s “personhood,” (b) birth planning, (c) quality time with baby after birth, (d) memory making, and (e) opportunities to hold and care for the baby. Memorials and the option of organ and/or breast milk donation were also meaningful. This review demonstrated that perinatal palliative care is a valuable resource when presented as an option for families with a lethal fetal diagnosis. It fits well within the midwifery model of shared decision making and can be part of midwifery care even where a formal program does not exist. Opportunities for research include: (a) PPC in low-resource settings and (b) integration into midwifery education.

Degree Name

M.S. Nurse-Midwifery

Document Type

Masterʼs thesis

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