Care Experiences of Women Who Used Opioids and Experienced Fetal or Infant Loss

J Obstet Gynecol Neonatal Nurs. 2017 Nov-Dec;46(6):846-856. doi: 10.1016/j.jogn.2017.08.006. Epub 2017 Sep 23.

Abstract

Objective: To explore care experiences of women who used prescription or illicit opioids and experienced fetal or infant loss.

Design: A qualitative, descriptive design with secondary data analysis.

Setting: The Fetal and Infant Mortality Review program in an urban Midwestern county in the United States.

Participants: Eleven women with histories of prescription or illicit opioid use who experienced fetal or infant loss participated in the semistructured telephone or in-person interview portion of the mortality case review.

Methods: We used thematic analysis to analyze interview data.

Results: Five themes were identified related to the care experiences of participants throughout pregnancy and fetal/infant loss: Frustration and anger related to not being heard, feeling minimalized; Being overwhelmed with attempts to process and understand medical complications and outcomes; Profound sense of grief and coping with loss; Need to understand why and make difficult decisions; and Placing blame and guilt over death.

Conclusion: Our findings suggest that women who use opioids and experience fetal or infant loss have complex care, educational, and emotional needs. In the development of interventions for these women, it is important to address their unique and complex circumstances.

Keywords: infant loss; maternal narcotic use; maternal opioid use; perinatal bereavement; prenatal care.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / adverse effects*
  • Confusion
  • Female
  • Fetal Death*
  • Guilt
  • Humans
  • Infant, Newborn
  • Object Attachment*
  • Pregnancy
  • Prenatal Care / methods
  • Qualitative Research
  • Stillbirth / psychology*

Substances

  • Analgesics, Opioid