台灣婦女經歷死產後再次懷孕與生產的經驗

The Childbearing Experiences of Taiwanese Women After a Stillbirth

背景：周產期失落是家庭的創傷性事件，可能對婦女的心理健康造成嚴重的長期影響，包含再次懷孕與生產。因此，探討婦女於經歷失落後的再次懷孕之心理適應過程，才能瞭解周產期失落現象的全貌。目的：探討婦女於歷經死產後再次懷孕與生產的經驗。方法　採質性描述性研究設計，於台灣南部兩所區域醫院收案。立意取樣15位研究參與者，訪談次數以資料飽和為考量，共進行22次深度訪談，以內容分析法分析資料。結果　婦女在經歷死產後再次懷孕與生產的經驗，可以歸納為三個主題以及九個類目，三個主題分別為：期待又怕受傷害、如履薄冰以及再次懷孕有助於撫平失落。結論／實務應用　本研究結果有助於瞭解經歷死產婦女復原過程的全貌，研究建議健康照護提供者應瞭解及接納婦女再次懷孕的擔憂與反應，如此會有助於婦女於失落後獲得正面的再次懷孕與生產經驗。

Background: Perinatal losses are traumatic events for women and may have serious long-term consequences for the psychological health of women and subsequent pregnancies. Therefore, it is important to explore the psychological adaptation process of subsequent pregnancy after loss in order to understand the overall phenomenon of perinatal loss. Purpose: To explore the childbearing experiences of women who have experienced a prior stillbirth. Methods: This qualitative descriptive study targeted a purposive sample of 15 women who had prior personal experiences with stillbirth. A total of 22 in-depth interviews were conducted in order to ensure data saturation. Women who had experienced stillbirth at one of two teaching hospitals in southern Taiwan were recruited. Data were analyzed using content analysis. Results: Three themes were identified that captured the complex feelings of participants regarding their subsequent childbearing experiences: (1) looking forward to another pregnancy but afraid of being hurt again, (2) treading on thin ice, and (3) bearing another child helps heal the loss of the stillborn. Conclusions / Implications for Practice: The empirical data gathered in the present study helps build a more complete understanding of the process of recovery that women undergo following a stillbirth experience. In addition, the results suggest that healthcare professionals should be aware of and accept the worries and reactions of women during their subsequent pregnancy in order to help these women achieve a positive subsequent childbearing experience.