Morte e luto na maternidade: como pais e profissionais de saúde lidam com a perda

Abstract

Introduction: The death of a child before birth represents a great loss for the parents and all the family. Whatever the reason for fetal death, it is an event traumatizing for the woman, being remembered and feared in a next pregnancy. The involution of pregnancy puts dreams, hopes, expectations and existential waits that parents normally place on the birth of the child. O The moment of the fetal death news is very delicate, both for parents and family members, as well as for for the health professional who is affected by the situation and who must communicate the news and provide assistance to this woman throughout her hospitalization. Professionals are often not table to deal with their own emotions and feel unprepared to welcome and give support for patients and their families. Objectives: The general objective of this research was to study as women/mothers, assisted at the UFRJ Maternity School (ME/UFRJ), in addition to the health professionals who work in this institution, experience and face the situation of pregnancy loss due to fetal death. Thus, we sought to investigate this population the cognitive (perceptions and meanings) and emotional (feelings) aspects related to fetal death in women hospitalized at ME/UFRJ and in professionals who assist these women in a situation of miscarriage. Methodology: Based on descriptive design with qualitative character and convenience sample, participated 11 women hospitalized in the rooming-in and 08 professionals who provided assistance direct to the patient in a situation of pregnancy loss, more specifically in the sectors of Ultrasonography, Obstetric Center and Infirmaries of the institution. both participants were interviewed individually and the collected report was analyzed and processed according to with L. Bardin's Content Analysis Methodology, resulting in the following categories: a) For women in a situation of miscarriage: “Perceptions, meanings and feelings about pregnancy loss”; “Women's reactions to pregnancy loss”; “Reactions of women before hospitalization due to pregnancy loss”: “Conceptions and meanings about the birth of a child”; “Perception of family support in the face of loss gestational"; “Experiencing grief after pregnancy loss”: and “Perception of care by the multiprofessional team”. b) For health professionals: “Communication of the death of a baby”: “Dealing with the bereaved patient”: and “Professionals’ feelings towards women with pregnancy loss”. Results: It was observed that both women and health professionals health are affected by pregnancy loss, as they reported feeling powerless and frustrated with the situation. For women, the moment of fetal death is marked by shock and denial reactions, followed by a depressed mood, demotivation. low self-esteem and fear of further losses in later pregnancies. For the participants of study, it became clear that family and health team support is essential for the elaboration of this loss. For professionals to communicate the diagnosis of fetal death is one of the moments more delicate, which usually causes frustration and discomfort. Aiming to protect yourself psychically from the discomfort caused by the patient's pain, part of the professionals (N= 4) declared to assume a more “technical” posture, aiming to distance the suffering of patients. On the contrary, others (N=4) declared that they were able to develop a way of deal with the patient in a more welcoming and empathetic way, which can help to provide a space for the manifestation of pain of women who experience fetal death and who, commonly, are involves a psychic process of symbolic mourning for the pregnancy of a lost child.