It is obvious that I believe it is our role, as healthcare practitioners, to identify the risk and resilience factors in our patients that present with a miscarriage. However, our role as healthcare professionals is not simply to identify those at high or low risk of a significant negative response to the miscarriage. In my study of women in Nigeria who had experienced a miscarriage, the doctors and nurses were identified as their second most important source of support, second only to their spouses (1).
In order to identify the type of support required the healthcare professional needs to be able to distinguish between a normal grief reaction and a pathological reaction to the miscarriage. This can only be achieved if the woman is allowed to talk about the loss and her feelings about it. Essentially, a grief reaction will manifest as a preoccupation with and longing for what was lost plus painful recollections and reminders in everyday life (2) (3). A depressive reaction will manifest as symptoms in the woman: irritability, restlessness, lack of concentration, sleep disturbances and so forth (2); in other words, a preoccupation with herself.
Women will, more often than not, welcome any opportunity to discuss their loss (4). However, there are some that may find it difficult to do so, due to feelings of guilt and shame (5). It is therefore very helpful if the health care professional creates an opportunity for the woman to discuss the miscarriage and what it meant to her. Following a miscarriage, women may have a strong desire for recognition and validation of the loss, particularly from their health care providers, who can help them to explore the meanings of the miscarriage (3).
It has been confirmed by empirical research that women who receive counselling sessions, which were simply sessions where the women talked about the whole experience of the miscarriage, were more likely to show a decline in overall emotional disturbance (6).
...To be continued
No comments:
Post a Comment