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HLB001 Midwifery Question: Module 1: Basic Mental Health Care For Midwives Introduction to grief and loss during childbearing Clearly identify which posting you are responding to and in relation to which module Respond by critically analysing the posting to generate further discussion or an argument eg. The topic’s relevance to midwifery practice is clearly described and optimal midwifery care is discussed and supported from theory and research Answer: Kennedy outlines that the world health organization has reported that 45% of children’s deaths worldwide in 2015 were newborns. Stillbirths affect around 1% of all pregnancies (Lawn et al., 2016). In Australia last year, 1718 babies were stillborns. This was a rate of about 5stillborns per day according to the stillbirth foundation Australia. In these tragic events, Kennedy suggests that midwives can best assist the parents in grieving process that follows the death of a baby (Rollan et al., 2013). With sensitive care by health professionals psychological distress after pregnancy loss can be substantially reduced. This includes giving them factual, clear and comprehensible information in a warm, sensitive manner. The midwives reduce confusion of mothers on how to process the information and dealing with grieve ( Rollan et al, 2013). Interventions to get better mothers mental healthcare after stillbirths are significant aspects of excellent professional care (Cacciatore, 2013). Midwives have to provide mothers with sound evidence based choices in a timely version yet sensitive in order to achieve the right balance between beneficial guidance and harmful persuasion. Kennedy outlines that people deal with grieve differently, it’s the midwives responsibility to decide on the best way to deliver the information to the mother and how to help them process it (Rollan et al., 2013) . These include making memories of the baby by giving the mothers their babies to see when they are still warm and soft. However it should be done when the mothers are unsure of what they should do and in shock so as to help them avoid excessive mental stress (Cunningham et al., 2014). The stillborn should be treated as a live baby when handed to the mother, this will encourage memory making as opposed to treating the stillborns otherwise. Kennedy also outlines that the midwives would encourage them to share the memories of their babies within family, relatives and immediate care systems and also through writing. Memory sharing reduces symptoms of PTSD and anxiety; Its shown that poorer mothers mental health is associated with dissatisfaction with the professional support, less time since dead of the baby, mothers desire to talk further about their babies and a little memory sharing actions. Continuity of care is the best way to provide supportive care to the families. Women required to spend more time with healthcare providers to elucidate common psychological effects that follow pregnancy loss. Further guidance to conflicting emotions to conceive again following stillbirths is also needed (Downe et al., 2013). Kennedy confirms that practices regarding the death of a baby have changed in the western society, in Australia midwives are expected to provide all women with midwifery care that is culturally safe. Australia has a variety of cultures. Due to this cultural diversity, cultural safety has evolved to cultural sensitivity and midwives apply the concepts of cultural safety to provide safe care which is also woman centered (Jeong et al., 2011). Midwives must ensure when working with these women they talk with parents about the processes there are regarding the grieving of a child. Over time hospital care practices and professionals have evolved to respond to and recognize perinatal bereavement (Roose & Blanford, 2011). Healthcare providers now provide loss care that facilitates mourning. In Australia, the midwifery and nursing staff acknowledge and act in response to grief of loss: they encourage parents to hold, see and even take pictures of their stillborn babies; they also support bereaved parents with memorial and funeral service arrangements (Roose & Blanford, 2011). Extra care is taken in a few maternity facilities to ensure no crying babies’ exposure to bereaved mothers in maternity wards (Rollans et al., 2013). The midwives also provide mothers that experience loss with brochures’ on counseling and support services and referrals if they are needed before they leave the hospital (Cacciatore et al., 2009). References: Cacciatore, J., Schnebly, S., & Froen, J. F. (2009). The effects of social support on maternal anxiety and depression after stillbirth. Health & social care in the community, 17(2), 167-176. Cacciatore, J. (2013, April). Psychological effects of stillbirth. In Seminars in Fetal and Neonatal Medicine (Vol. 18, No. 2, pp. 76-82). WB Saunders. Cunningham, F., Leveno, K., Bloom, S., Spong, C. Y., & Dashe, J. (2014). Williams Obstetrics, 24e. McGraw-Hill. Downe, S., Schmidt, E., Kingdon, C., & Heazell, A. E. (2013). Bereaved parents’ experience of stillbirth in UK hospitals: a qualitative interview study. BMJ open, 3(2), e002237. Jeong, S. Y. S., Hickey, N., Levett-Jones, T., Pitt, V., Hoffman, K., Norton, C. A., & Ohr, S. O. (2011). Understanding and enhancing the learning experiences of culturally and linguistically diverse nursing students in an Australian bachelor of nursing program. Nurse education today, 31(3), 238-244. Lawn, J. E., Blencowe, H., Waiswa, P., Amouzou, A., Mathers, C., Hogan, D., … & Shiekh, S. (2016). Stillbirths: rates, risk factors, and acceleration towards 2030. The Lancet, 387(10018), 587-603. Rollans, M., Schmied, V., Kemp, L., & Meade, T. (2013). ‘We just ask some questions…’the process of antenatal psychosocial assessment by midwives. Midwifery, 29(8), 935-942. Roose, R. E., & Blanford, C. R. (2011). Perinatal grief and support spans the generations: parents’ and grandparents’ evaluations of an intergenerational perinatal bereavement program. The Journal of perinatal & neonatal nursing, 25(1), 77-85. Strand, L. B., Barnett, A. G., & Tong, S. (2012). Maternal exposure to ambient temperature and the risks of preterm birth and stillbirth in Brisbane, Australia. American journal of epidemiology, 175(2), 99-107.

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