As the basis of my reflective assignment, I have incorporated Gibb’s Cycle. During my Placement I have reflected on a particular experience that was thought-provoking. The bereavement and grief of a mother who has experienced a miscarriage is one of the most important issues to experience as a student midwife. There is not any knowledge that can be gained from a book effectively in comparison to an actual experience that will gain the relevant skills of caring. “A miscarriage is the unintentional early ending of pregnancy by a Natural or accidental accident.” (The World Book Encyclopaedia, 1980).
My focuses in this assignment is mainly the grief the mother experiences due to the death of her child. By my second week of placement in the antenatal ward, I had already developed my interpersonal skills with the women. When I had my first experience with a woman who had a miscarriage, I understood the difficulty that arises in this profession. It immediately became clear that there is more than just skill and knowledge associated with the profession but deep engagement and effective communication with others. This particular experience had never occurred to me. I was always under the impression that the profession dealt with woman and baby.
My Midwife introduced herself and myself to the woman. I remained silent as I could not use my usual conversational tactics which mainly focused on the well-being of the baby. The midwife sat on the bed beside the woman and held her hand. Even basic body language skills could convey that she was nervous and tense. The midwife spoke to the woman in a gentle easy tone. The midwife was completely involved and was sympathetic to the woman and used her own experience of having had a miscarriage herself as a way of understanding to the woman. “The most beneficial resources that a health care professional can offer to a grieving family are a non – judgement, deep sense of caring and personal involvement.” (Canadian Paediatric Society. 2001).
The midwife used eye contact and helpful gestures by simply involving her in her own experience and at the same time the midwife recognised the uniqueness of the situation. The care and support determined by personal significance of miscarriages are unique and individual to each woman. Interpersonal stress is clear when the woman cannot synchronise grieving. There is no pattern for every person’s response to death of their baby as grief for each individual is intrinsically unique. (Midwifery and Obstetrics, All Wards and Departments, February 2007).
By using her own experience, the midwife developed a level of trust with the woman. I now see it as a profession with an immense personal involvement. The concept of partnership between the woman and the midwife is essential and is based on a mutual trust (Guidelines for Midwives, September 2001). I remained silent throughout the situation as I had not yet developed competence involving miscarriages.
Any type of experience involving a miscarriage is thought-provoking and will initiate an emotional response. My feelings were sympathetic and distressed. I was perplexed at the situation and did not understand how to deal with the incident. I felt I couldn’t provide any form of comfort as both the woman and the midwife had experienced miscarriages. The midwife held the woman’s hand sympathetically but also encouraged the woman. Hope for the future is all she could provide. In closely involved situations like this, midwives may feel the isolation and loneliness that the grieving mother experiences (Mayes’ Midwifery, 2004). I could feel the pain in me, penetrating through my body. Emotions are also felt physically and we carry them in different parts of the body (Mayes’ Midwifery, 2004) i.e. I felt sadness in my stomach and heart.
I felt inadequate as if I had nothing to offer in the situation. I could not relate to the woman in the same in-depth approach in which the midwife had. My main thoughts from this experience were how the woman felt. Surely this was agonising pain that I’ve probably never felt before and from the experience I hope I never will. I think the importance of the experience for me was the invaluable knowledge I received from the midwife.
There are no guidelines or rules on assessing grief, only policies relevant to this type of care. Each midwife has a different way of caring for each woman. There is no one person better equipped to care than an other. Each midwife should have something to offer. As midwives, we offer ourselves and in doing so we learn from grieving families. As this was my first experience, I felt as though I had nothing to offer. I believe that the pain I felt will always be there in these situations, but I hope I can resist the pain to that profundity in experiences in the future.
Although it seems obvious that the negatives extend beyond the positives in this experience, it presents itself with optimism for the future. Supportive encouragement form the midwife represents hope for the woman. Bereaved parents are deeply grateful and remember the care they received throughout their lives (Mayes’ Midwifery, 2004). They never forget the understanding, respect and genuine care, clearing shown by the midwife that they receive from caregivers who become as important to them as other memories in life (Midwifery and Obstetrics, All wards and Departments, February 2007).
The situation gave me a chance to reflect and understand the issues relevant to the experience. From my work placement, I have become more confident and understanding to these fragile circumstances. I have developed a broader view of the world and life. The woman however is left in a fragile psychological grieving state. It is unknown to some women how to overcome the situation. Delayed grief can sap your energy and can leave its mark on you for longer than can be imagined (Self Care for Parents, 2000). As midwives we can only hope that the women can progress though life but we can only do so much in the profession. I did not understand exactly how the woman was feeling when she left the hospital that day.
I could only presume that she was riddled with grief or else in denial of the event. On another unpleasant note, for myself I realised that these situations were frequent. About 15 – 20% of pregnancy ends in miscarriage (Midwifery and Obstetrics, All wards and Departments, February 2007), a deplorable amount of pain and grief that woman around the world have, are and yet to endure. For me, it is one of the world’s most pessimistic effects to life. I have learned the real loss of a living infant to the mother of a child and the experience of it portrayed its realism. The mother had developed a close motherly bond with the infant. Death does not invalidate the relationship with a child (When your baby dies through miscarriage or stillbirth, 2002).