Seeing or not seeing: Taiwan's parents' experiences during stillbirth

Background: The findings of most quantitative studies and the clinical guidelines for encouraging or discouraging parents to see their stillborn babies remain diverse depending on country and culture of residence. There is still a lack of research comprehensively exploring the situational or cultural meanings of parents' decisions to face their stillborn infants. Objectives: Understanding the essence and structure of decision-making and seeing phenomena that parents go through during stillbirth of their child adds to the body of nursing knowledge and provides insight into how to care for this group of clients. Design: A descriptive phenomenological approach with multi-setting, multistage, and paired design was used. Setting: The study was conducted in maternity units in Taoyuan, Taiwan. Participants: A purposive sample of 12 couples (total = 24 subjects) who experienced stillbirth deliveries following a diagnosis of fetal death participated in this study. Methods: The participants' observations and in-depth interviews were recorded and analyzed according to Giorgi's methods. Results: Most parents expressed a sense of deep upset, of never anticipating seeing their deceased babies while some had no fear of how their babies' bodies would look. Two constituted patterns with five themes each emerged from the study: 1.(a) "Deciding to see the stillborn baby" shows the seeing event as an experience of "believing", (b) "avoiding regret", (c)"an opportunity to say farewell", (d) "a chance for imprinting the stillborn infant in one's memory", and (e) "shock of seeing". 2.(a) "Deciding not to see the stillborn baby" demonstrates the meaning of not seeing is "cutting the attachment to the stillborn baby," (b) "preventing memory imprinting," (c) "avoiding guilt and suffering", (d) "pretending event closure", and (e) "the act of following a cultural taboo". Conclusions: Participants experienced acts of seeing and not seeing throughout their denial or facing of ongoing bereavement, which was influenced by their personal beliefs, readiness for the event, and social values. Health professionals need to understand the powerful interpretation of the "visual" meaning of the stillbirth experience and learn to be sensitive, empathetic and keep communication lines open in order to create and maintain a compassionate and caring environment. (C) 2013 Elsevier Ltd. All rights reserved.