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Woman and miscarriage
GALLOVÁ, Nikola
This bachelor thesis deals with the midwifery care of a woman with miscarriage. The thesis specifically focuses on the care of women, who suffered spontaneous miscarriage, ectopic pregnancy or artificial termination of pregnancy from the medical indication. The first goal of this thesis was to find out how midwives help to fulfil the needs of women, who suffered miscarriage, and the second goal was to find out the women's satisfaction with the midwifery care. This thesis is divided into theoretical and practical part. The definition of miscarriages and abortions according to Czech legislation is described in the theoretical part. The theoretical part further contains of detailed description of causes, clinical stages, diagnostics and therapy of spontaneous miscarriage and ectopic pregnancy. The methods and complications of artificial termination of pregnancy in the first and second trimester are also discussed there. A very important part of the theoretical part is created by the chapter that deals with psychosocial aspects of miscarriage. This chapter also covers the topics of experiencing miscarriage from a Man's point of view and the process of mourning, but this chapter is also dedicated directly to the topic of midwife care of a woman with miscarriage. Qualitative research was carried out in the practical part of this thesis and its goals were to find out how midwives help to fulfil the needs of women, who suffered miscarriage, and to find out the women's satisfaction with the midwifery care. The research data were gained with the help of semi-structured interviews and they were carried out with seven respondents, who at least once in a lifetime suffered miscarriage. The interviews were recorded with the consent of respondents, then transcribed, analyzed with the "pencil-paper" method and processed into six categories (Communication, Awareness, Needs, Midwifery care, Partner and Mourning). These categories were further subdivided into subcategories. Three main research questions were chosen for the research part of the thesis. The first question examined how midwives satisfy bio-psycho-socio-spiritual needs of women, who suffered miscarriage. The research showed that the midwifery care of biological needs is generally precise but the care of psycho-socio-spiritual needs is adequate only for women, who suffered miscarriage in the second trimester of pregnancy. For women, who suffered miscarriage in the first trimester, these needs were not in most cases sufficiently satisfied. The second research question sounded how women evaluate the midwifery care during the miscarriage. Research suggests that women were mostly satisfied with the care of their physical side and with the stuff expertise but some respondents were not satisfied with the care of the psychical side. The women mostly missed empathy in communication and the interest in women's experiencing of the miscarriage and they expressed the lack of information. The third research question examined how midwives help women to manage their situation. The answers of respondents showed that the biggest help for women is empathy, appropriate communication, sufficient information and interest in their experiencing of miscarriage and their psyche and also ensuring their privacy and intimacy. The women also appreciated when their partner could be present during miscarriage or at least during hospitalization after miscarriage. The research investigation showed that for women, miscarriage is really very challenging and traumatizing experience. It showed up that appropriate attitude of midwives can really help women to manage their situation. According to the research results, there was created an instructional leaflet for midwives dealing with the midwife care of women with miscarriage. The leaflet can serve midwives as help during the care of these women and it can help to improve their care.
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