Stillbirth, pregnancy after loss, couples, phenomenology
Background: Despite advances in maternity care, 2.6 million babies die at or before their birth each year across the globe. The majority of couples will proceed to a pregnancy after loss, often within a very short timeframe of their index loss. However, little is known about how couples, as a unit, negotiate the experience of pregnancy after loss. Aim: To understand how couples, as a dyad, make sense of a pregnancy after stillbirth. Method: The experiences of eight heterosexual couples, who were pregnant again in the immediate pregnancy after stillbirth, was explored using Interpretive Phenomenological Analysis (IPA). Data were collected by joint, semi-structured, face-to-face interviews with a convenience sample. Interviews were audiotaped, transcribed verbatim and analysed using IPA principles. To ensure both the individual and dyadic experiences were explored an additional layer of data analysis was performed. Findings: Two superordinate themes emerged from the data ‘Hoping for a born alive baby’ and ‘Journey of Loss. The first theme, ‘Hoping for a born alive baby’ was the aim of all of the couples in a pregnancy after stillbirth. The processes of negotiated decision-making and lived experience of a subsequent pregnancy were explored. Couples made sense of their experiences of pregnancy after loss via the lens of the death of their babies. In the second theme, ‘Journey of Loss’, couples spoke about the unexpected death of their babies, their experiences at the time of loss and in its aftermath, and the impact that these events had on them as a couple. Conclusion and Implications: Perinatal loss and pregnancy after loss are common occurrences in maternity services. The original findings of this study adds to the understanding of pregnancy after loss, from a couples’ perspective and will assist in the provision of appropriate support services for couples both at the time of loss and in the pregnancy that follows. How couples negotiate the experiences of loss and subsequent pregnancy will help to inform policy and improve services for future couples pregnant after stillbirth.