Intrapartum fetal death and doctors: a qualitative exploration

Abstract

Introduction: The death of an infant during a pregnancy is profoundly traumatic, both for the parents and for the involved healthcare professionals. Most research focuses on the impact of antenatal stillbirth with very little research examining the specific impact an intrapartum fetal death has on obstetricians. The aim of this study was to provide an in-depth qualitative exploration of the attitudes and responses that Irish obstetricians have following direct involvement with an intrapartum fetal death. Material and methods: Qualitative semi-structured interviews were used. Interpretative phenomenology was used for data analysis. The setting was a tertiary university maternity unit in Ireland with 8200 deliveries per year. Ten obstetricians were purposively sampled. The main outcome measures were the attitudes and responses of Irish obstetricians following exposure to an intrapartum death. Results: Obstetricians were profoundly and negatively affected by a personal involvement with an intrapartum death. Analysis of the data revealed two superordinate themes; the doctor as a person, and supporting each other. The doctor as person was characterized by two subordinate themes; emotional impact and frustration. Supporting each other was also characterized by two subordinate themes; an unmet need and incidental support and what might work. Conclusions: Obstetric doctors who are directly involved in an intrapartum death are the second victims of this event and this is something that needs to be acknowledged by the public, by the healthcare system, by the media and by the doctors themselves. The development of effective emotional support interventions for all obstetricians is extremely important.