A peaceful death is an acceptable outcome of nursing care (Henderson, 1966). Conversely, a maternal mortality is an adverse incident that continuous to plaque many third world countries (WHO, 2018). Reduction of maternal mortality has been an important indicator of the success of both the millennium development goals (Reinke & Supriyatiningsih, 2017) and the sustainable development goals (World Bank Group, 2014). Hence, much resource and efforts have been directed at curbing the menace. The impact of a maternal death on the family, community and society has been largely studied (Bazile et al., 2015; Molla, Mitiku, Worku, & Yamin, 2015), however its implications for midwifery practice has not been largely explored. The purpose of this study was to explore the experiences of midwives’ whose clients died during the peripartum period and to unearth the effects of their experience on their personal lives and practice as midwives.
Methods: This case study, through a series of in-depth interviews conducted over six months, sought to answer the questions: how do midwives conceptualise death? what processes do the midwives undergo to resolve and recover from their experiences of maternal death? Four midwives were recruited from three district hospitals in Ghana using purposive sampling and snowballing. The in-depth interviews were audio-recorded and transcribed into Fante and subsequently translated into English. Colaizzi’s method (1978) was employed to analyse the data.
Results: Three main themes and several sub themes were generated:
Theme 1: “the midwives’ concept of death”: I failed: I am a failure; A regrettable loss; an indelible scar.
Theme 2: the initial reaction to a maternal death: psychological; emotional and spiritual.
Theme 3: Perceived preparedness to manage maternal death: I hid my head in the cloud; no training after employment; experiential knowledge.
Participants’ descriptions revealed a traumatic experience following a maternal death. There was evidently a lack of support, and opportunities of debriefing was sparsely available. The emotional and psychological impacts of maternal death on the midwives were enormous but midwifery training did not adequately prepare the midwives for managing maternal deaths.
Conclusions: The findings generate new knowledge: midwives’ experiences of maternal deaths, and it highlights it’s impact on midwifery practice. The need for curriculum development and the establishment of pathways of support for midwives following a maternal death is revealed.
Global implications for midwifery training and practice
For quality peripartum care, midwifery education and practice must endeavour to care and support the midwives in their practice. Further investigations are needed to develop a detailed process of coping and recovery for midwives who are confronted with experiences of maternal deaths.