Midwifery care of the grieving mother: how the decisions are made

During a study of midwives' care of mothers relinquishing their baby for adoption forty midwives were interviewed using a semi-structured interview format. Because the literature on relinquishing mothers suggests that there are certain similarities between them and bereaved mothers, and because this was an area midwives were thought to be knowledgeable about and comfortable with, midwives' care of the bereaved mother was examined prior to discussing their care of the relinquishing mother. Although some attempts have been made by midwife researchers to describe the care given by midwives to the bereaved mother, no literature has been found relating to either the decision-making process preceding that care or to midwives' care of the mother experiencing loss through relinquishment. Midwives perceive very clear limitations on the advice which it is appropriate for them to give. They are aware of certain constraints which limit their decision-making. The decisions which midwives consider are appropriate for them to take are those relating to the environment in which the grieving mother is cared for. Midwives are happy to support the woman in her wish to be transferred home soon after the birth. Despite considerable knowledge, midwives are reluctant to discuss with the grieving mother the interventions which may facilitate the resolution of her grief. The data suggest that midwives do not always apply their theoretical knowledge in their practice.