Sailing Against the Tide: Taiwanese Women’s Journey From Pregnancy Loss to Motherhood

Hui-Lin Sun, Marlene Sinclair, George Kernohan, Te-Hsin Chang, Hiliary Patterson

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To understand the experiences of Asian women inTaiwan who are adjusting to motherhood following previouspregnancy loss.Study Design and Methods: Phenomenology was used asthe study design, and interviews were used to collect data ina medical center in Northern Taiwan with six women who hadgiven birth to a healthy baby after previous pregnancy loss.Following ethical approval, interviews were audio-recorded,transcribed, and analyzed to develop data themes.Results: The nautical metaphor was chosen because of thefact that Taiwan is an island and surround by sea. The sea hasdeep cultural meaning of uncertainty in life for the Taiwanesepeople. A metaphor of “sailing against the tide” emergedfrom the data to depict three stages of the women’s journey:remembering the previous journey of loss; the rising sunbrings new life within; and changing tide brings new birth.The essence of their journey through the pregnancy and birthwas a permutation of fear, uncertainty, and a deep desire forreassurance of fetal well-being.Clinical Implications: This study reinforces the diffi cultiesthat women have after a pregnancy loss, but examines itwith a unique cultural focus. Nurses and midwives can usethese fi ndings to develop caring and understanding practicesdesigned to help women in these circumstances. Pregnancyafter a loss is never the same as a previous pregnancy, and isperceived as different from a pregnancy that other “normal”pregnant women have. Women need nurses and midwiveswho can provide comprehensive practical, physical, culturallyspecifi c, psychosocial, and spiritual support to help themsuccessfully chart their journey out of profound loss.
Original languageEnglish
Pages (from-to)127-133
JournalMCN: American Journal of Maternal/Child Nursing
Volume3
Publication statusPublished - Mar 2011

Bibliographical note

Reference text: References
Armstrong, D. S. (2004). Impact of prior perinatal loss on subsequent
pregnancies. Journal of Obstetric, Gynecologic, and Neonatal
Nursing, 33(6), 765-773. doi:10.1177/0884217504270714
Armstrong, D. S., Hutti, M. H., & Myers, J. (2009). The infl uence of prior
perinatal loss on parents’ psychological distress after the birth of a
subsequent healthy infant. Journal of Obstetric, Gynecologic, and
Neonatal Nursing, 38(6), 654-666. doi:10.1111/j.1552-6909.2009.01069.x
Bergner, A., Beyer, R., Klapp, B. F., & Rauchfuss, M. (2008). Pregnancy
after early pregnancy loss: a prospective study of anxiety, depressive
symptomatology and coping. Journal of Psychosomatic Obstetrics
and Gynaecology, 29(2), 105-113. doi:10.1080/01674820701687521
Bureau of National Health Insurance, Taiwan, & ROC. (1998-2008). Total
number of patients—National health insurance annual statistical report.
http://www.nhi.gov.tw/english/webdata.asp?menu=11&menu_
id=296&webdata_id=1942
Cote-Arsenault, D. (2006). Threat appraisal, coping, and emotions
across pregnancy subsequent to perinatal loss. Nursing Research,
56(2), 108-116. doi:00006199-200703000-00006.
Cote-Arsenault, D., Bidlack, D., and Humm, A. (2001). Women’s emotions
and concerns during pregnancy following perinatal loss.
MCN, American Journal of Maternal Child Nursing, 26(3), 128-134.
Cote-Arsenault, D., & Dombeck, M. T. (2001). Maternal assignment of fetal
personhood to a previous pregnancy loss: relationship to anxiety in the
current pregnancy. Health Care for Women International, 22(7), 649-665.
Cote-Arsenault, D., & Donato, K. L. (2007). Restrained expectations in
late pregnancy following loss. Journal of Obstetric, Gynecologic,
and Neonatal Nursing, 36(6), 550-557. doi:10.1111/j.1552-6909.2007.
00185.x
Cote-Arsenault, D., Donato, K. L., & Earl, S. S. (2006). Watching and
worrying: Early pregnancy after loss experiences. MCN, American
Journal of Maternal Child Nursing, 31(6), 356-363. doi:00005721-
200611000-00005
Cote-Arsenault, D., & Mahlangu, N. (1999). Impact of perinatal loss on
the subsequent pregnancy and self: Women’s experiences. Journal
of Obstetric, Gynecologic, and Neonatal Nursing, 28(3), 274-282.
Cote-Arsenault, D., & Marshall, R. (2000). One foot in-one foot out:
Weathering the storm of pregnancy after perinatal loss. Research in
Nursing and Health, 23(6), 473-485. doi:10.1002/1098-240X(200012)
23:6<473::AID-NUR6>3.0.CO;2-I
Cuisinier, M., Janssen, H., de Graauw, C., Bakker, S., & Hoogduin, C.
(1996). Pregnancy following miscarriage: Course of grief and some
determining factors. Journal of Psychosomatic Obstetrics and Gynaecology,
17(3), 168-174.
DeBackere, K. J., Hill, P. D., & Kavanaugh, K. L. (2008). The parental experience
of pregnancy after perinatal loss. Journal of Obstetric,
Gynecologic, and Neonatal Nursing, 37(5), 525-537. doi:10.1111/
j.1552-6909.2008.00275.x
Franche, R. L., & Mikail, S. F. (1999). The impact of perinatal loss on adjustment
to subsequent pregnancy. Social Science and Medicine,
48(11), 1613-1623. doi:S0277953698004389
Ganaba, R., Marshall, T., Sombie, I., Baggaley, R. F., Ouedraogo, T. W., &
Filippi, V. (2010). Women’s sexual health and contraceptive needs
after a severe obstetric complication (“near-miss”): A cohort study
in Burkina Faso. Reproductive Health, 7, 22. doi:10.1186/1742-4755-
7-22
Hiraki, A. (1992). Tradition, rationality, and power in introductory nursing
textbooks: A critical hermeneutics study. Advances in Nursing
Science, 14(3), 1-12.
Ho, S. W., & Brotherson, S. E. (2007). Cultural infl uences on parental
bereavement in Chinese families. Omega: Journal of Death and
Dying, 55(1), 1-25.
Hsu, M. T., Tseng, Y. F., Banks, J. M., & Kuo, L. L. (2004). Interpretations of
stillbirth. Journal of Advanced Nursing, 47(4), 408-416. doi:10.1111/
j.1365-2648.2004.03119.x
Hsu, M. T., Tseng, Y. F., & Kuo, L. L. (2002). Transforming loss: Taiwanese
women’s adaptation to stillbirth. Journal of Advanced Nursing,
40(4), 387-395. doi:2386 DOI: 10.1046/j.13652648.2002.02386.x
Hughes, P., Turton, P., & Evans, C. D. (1999). Stillbirth as a risk factor for
depression and anxiety in the subsequent pregnancy: Cohort study.
British Medical Journal, 318(7200), 1721-1724.
Hunfeld, J. A., Agterberg, G., Wladimiroff, J. W., & Passchier, J. (1996).
Quality of life and anxiety in pregnancies after late pregnancy loss:
A case-control study. Prenatal diagnosis, 16(9), 783-790. doi:10.1002/
(SICI)1097-0223(199609)16:9<783::AID-PD943>3.0.CO;2-7
Kavanaugh, K., Trier, D., & Korzec, M. (2004). Social support following
perinatal loss. Journal of Family Nursing, 10(1), 70-92. doi:10.1177/
1074840703260905
Mann, J. R., McKeown, R. E., Bacon, J., Vesselinov, R., & Bush, F. (2008).
Predicting depressive symptoms and grief after pregnancy loss.
Journal of Psychosomatic Obstetrics and Gynaecology, 29(4), 274-279.
doi:10.1080/01674820802015366
O’Leary, J. (2004). Grief and its impact on prenatal attachment in the
subsequent pregnancy. Archives of Women’s Mental Health, 7(1),
7-18. doi:10.1007/s00737-003-0037-1
O’Leary, J., & Thorwick, C. (2008). Attachment to the unborn child and
parental mental representations of pregnancy following perinatal
loss. New Directions in Psychotherapy and Relational Psychoanalysis,
2(3), 292-320.
Parahoo, K. (1997). Nursing research: Principles, process and issues.
Basingstoke: Macmillan.
Peterson, G. (1994). Chains of grief: Impact of perinatal loss in subsequent
pregnancy. Pre and Perinatal Psychology Journal, 9(2), 149-
158.
Phipps, S. (1985). The subsequent pregnancy after stillbirth: Anticipatory
parenthood in the face of uncertainty. International Journal of
Psychiatry in Medicine, 15(3), 243-264.
Radestad, I., Surkan, P. J., Steineck, G., Cnattingius, S., Onelov, E., &
Dickman, P. W. (2009). Long-term outcomes for mothers who have
or have not held their stillborn baby. Midwifery, 25(4), 422-429.
doi:10.1016/j.midw.2007.03.005
Robertson, P. A., & Kavanaugh, K. (1998). Supporting parents during
and after a pregnancy subsequent to a perinatal loss. The Journal
of Perinatal and Neonatal Nursing, 12(2), 63-71.
Sinclair, M. K., Gardner, J., Gillen, P., Boreland, Z., & Hood R (2001).
Analyses of the records of maternity patients deemed as low-risk
on admission and of former patients’ perceptions of maternity
care. Report prepared for Down Lisburn Trust and accessible from
the Doctoral Midwifery Research Society publications page www.
doctoralmidwiferysociety.org/Recent_Papers.aspx
Smith, J. A. (1995). Semi-structured interviewing and qualitative analysis.
In J. A. Smith, R. Harre, & L. V. Langenhove (Eds.), Rethinking
methods in psychology (pp. 9-26). London: Sage.
Smith, J. A., Jarman, M., & Osborn, M. (1999). Doing interpretative phenomenological
analysis. In M. M. K. Chamberlain (Ed.), Qualitative
health psychology: Theories and methods (pp. 218-240). London:
Sage.
Theut, S. K., Pedersen, F. A., Zaslow, M. J., & Rabinovich, B. A. (1988).
Pregnancy subsequent to perinatal loss: Parental anxiety and depression.
Journal of the American Academy of Child and Adolescent
Psychiatry, 27(3), 289-292. doi:10.1097/00004583-198805000-00004
Turton, P., Hughes, P., Evans, C. D., & Fainman, D. (2001). Incidence, correlates
and predictors of post-traumatic stress disorder in the pregnancy
after stillbirth. British Journal of Psychiatry 178(6), 556-560.
Wallerstedt, C., Lilley, M., & Baldwin, K. (2003). Interconceptional counseling
after perinatal and infant loss. Journal of Obstetric, Gynecologic,
and Neonatal Nursing, 32(4), 533-542.
Wheeler, S. (2000). A loss innocence and a gain in vulnerability: Subsequent
pregnancy after a loss. Illness, Crisis and Loss, 8(3), 310-326.

Keywords

  • Lived experience
  • Motherhood
  • Pregnancy loss
  • Subsequent pregnancy

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