Midwifery Continuity of Care in a Subsequent Pregnancy After Perinatal Loss: A Scoping Review of Qualitative Evidence.

Abstract

Continuity of care during the perinatal period often leads to better psychosocial wellbeing for parents. Midwifery continuity of care (MCoC) is one such continuity of care model; however, there is little evidence regarding MCoC for the psychosocial wellbeing of bereaved parents in subsequent pregnancies. To synthesise perceptions of care related to psychosocial wellbeing where MCoC has been provided in a subsequent pregnancy. Eight databases and Google Scholar were searched using 'psychosocial wellbeing', 'midwifery continuity of care' and 'subsequent pregnancies after perinatal loss' as search terms. Studies containing primary data regarding parents' experiences of MCoC in a subsequent pregnancy after loss were included. Relevant data were analysed using a meta-aggregative approach, guided by JBI methodology. Aggregation of four studies generated an overarching finding of 'Compassionate, trauma-informed care should be a key component of pregnancy after loss care', with four lines of action: 'Relationships in MCoC are key to supporting parents' psychosocial wellbeing in pregnancy after loss', 'Parents value midwives with bereavement expertise and knowledge of pregnancy after loss care', 'MCoC can restore confidence and empower parents in a pregnancy after loss' and 'MCoC that prioritises accessibility, attentiveness and care coordination will support parents in pregnancies after loss'. The trauma-informed, compassionate care principles found in MCoC show significant potential to support bereaved parent's psychosocial wellbeing in pregnancy after loss.