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身披闪亮铠甲的骑士与穿着救生衣的(母)亲:新冠疫情期间女性在反复早期妊娠丢失时独自争取护理的经历

Knights in shining armour and (M)others in life jackets: Women's experiences of advocating for care alone when suffering recurrent early pregnancy loss during the SARS-CoV-2 pandemic.

作者信息

Kent-Nye Flora E, Sheen Kayleigh S, Burgess Karen, Oza Munira, Magee Laura A, Jurković Davor, Silverio Sergio A

机构信息

Department of Women & Children's Health, King's College London, London, UK.

Department of Social Sciences, University of the West of England Bristol, Bristol, UK.

出版信息

BMC Public Health. 2025 Jan 29;25(1):367. doi: 10.1186/s12889-024-20882-2.

Abstract

BACKGROUND

Recurrent early pregnancy loss [rEPL] is a traumatic experience, marked by feelings such as grief and depression, and often anxiety. Despite this, the psychological consequences of rEPL are often overlooked, particularly when considering future reproductive health or approaching subsequent pregnancies. The SARS-CoV-2 pandemic led to significant reconfiguration of maternity care and a negative impact on the perinatal experience, but the specific impact on women's experience of rEPL has yet to be explored. This study aimed to examine the impact of changes to early pregnancy loss care and social restrictions during the pandemic on women's experience of rEPL.

METHODS

A qualitative interview study design was employed, with semi-structured interviews conducted virtually. A total of 16 women who had suffered two or more early pregnancy losses (≤ 14 weeks gestation) during the SARS-CoV-2 pandemic in the United Kingdom participated. Data were recorded, transcribed, and analysed by hand, following a Classical Grounded Theory Analysis, appropriate for cross-disciplinary health research.

RESULTS

Iterative and inductive analysis generated the theory 'Knights in Shining Armour and (M)others in Life Jackets', which describes women's experience of advocating for care alone, when suffering rEPL during the pandemic. This theory was derived from the way in which three emergent themes inter-related: (1) Dismantling Validation; (2) Preserving an Identity of Motherhood; and (3) Support Waning.

CONCLUSIONS

This study affirms recent findings of devalued maternity care during the pandemic, and magnification of pre-pandemic issues with EPL care, such as a lack of support or perceived empathy.

摘要

背景

复发性早期妊娠丢失(rEPL)是一种创伤性经历,其特征是悲伤、抑郁等情绪,且常常伴有焦虑。尽管如此,rEPL的心理后果往往被忽视,尤其是在考虑未来生殖健康或后续妊娠时。严重急性呼吸综合征冠状病毒2(SARS-CoV-2)大流行导致产科护理发生重大调整,并对围产期体验产生负面影响,但对女性rEPL体验的具体影响尚待探索。本研究旨在探讨大流行期间早期妊娠丢失护理的变化及社会限制对女性rEPL体验的影响。

方法

采用定性访谈研究设计,通过虚拟方式进行半结构化访谈。共有16名在英国SARS-CoV-2大流行期间经历过两次或更多次早期妊娠丢失(妊娠≤14周)的女性参与。数据记录、转录后,按照适用于跨学科健康研究的经典扎根理论分析方法进行手工分析。

结果

迭代归纳分析产生了“穿着闪亮铠甲的骑士和穿着救生衣的(准)母亲”这一理论,该理论描述了女性在大流行期间遭受rEPL时独自争取护理的经历。这一理论源于三个新出现的主题相互关联的方式:(1)拆除确认;(2)保持母亲身份认同;(3)支持减弱。

结论

本研究证实了近期关于大流行期间产科护理被贬低以及大流行前早期妊娠丢失护理问题(如缺乏支持或缺乏同理心)被放大的研究结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61f2/11776267/405b5f5f01b3/12889_2024_20882_Fig1_HTML.jpg

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