Existential challenges due to severe pre-eclampsia when becoming parents

Midwifery. 2021 Jun:97:102967. doi: 10.1016/j.midw.2021.102967. Epub 2021 Mar 2.

Abstract

Objectives: To deepen the understanding of parents' existential challenges and experiences when having a premature infant due to the mother's pre-eclampsia.

Design: Two empirical studies based on reflective lifeworld research (RLR), were conducted to investigate parents' experiences of having a premature infant due to mother's pre-eclampsia. A further abstraction was possible. The two essences were synthesised into a general structure. Then, a philosophical examination of the existential issues was done using Karl Jaspers' concept of limit situation and health theory outlined by Dahlberg and Segesten.

Setting: Maternity ward and neonatal intensive care unit.

Participants: Nine mothers and six fathers.

Findings: The findings revealed the experiences of a vulnerable group of parents in the maternity ward and in the neonatal intensive care unit (NICU). The parents faced a paradoxical experience. They experienced mothers' severe illness and in some cases accompanied by the possibility of death, at the same time they experienced the joy of becoming parents. The premature birth and the mother's severe symptoms revealed the intertwinement of biological and existential features. Pre-eclampsia restricted the mothers from fulfilling the major project in their lives: to become real mothers. These experiences were elucidated by the concept of limit situations as suffering, struggle, death, and paradoxes of life as well as the health theory with its biological and existential dimensions.

Key conclusion: Some parents experienced closeness to death and the beginning of life as almost intertwined. These two fundamental facets of life are connected to existential features and challenges. The study also underlined the antinomies of life; suffering and facing severe illness that could cost both the mother's and infant's lives, and at the same time feeling the happiness of becoming parents.

Implications for practice: Health professionals should know how these experiences affect parents. They should be sensitive when approaching mothers and fathers in such situations. The families' vulnerability must be considered within the physical space of health services. If the parents needs to talk, time and staff should be available to meet their needs.

Keywords: Death; Existential; Health; Jaspers; Life; Limit situation; Parents; Pre-eclampsia; Premature.

MeSH terms

  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Intensive Care Units, Neonatal
  • Mothers
  • Parents
  • Pre-Eclampsia*
  • Pregnancy