Mothering disrupted by illness: a narrative synthesis of qualitative research

Title. Mothering disrupted by illness: a narrative synthesis of qualitative research. Aim. This paper is a report of a literature review of qualitative empirical research investigating women's experiences of mothering disrupted by illness. Background. As a primary identity, motherhood is endangered by illness. Illness can interfere with a woman's ability to mother her child/children. Healthcare professionals regularly fail to acknowledge a woman's dual identities of mother and patient. Data Sources. CINAHL, Medline, PsychInfo, Scopus and Sociological abstracts were searched 1980-2009. Methods. A narrative synthesis was used, with quality appraisal guided by the Critical Appraisal Skills Programme method. Concepts were analysed thematically, explicating common experiences of women disrupted in their mothering by illness. This allowed for both descriptive and narrative synthesis to occur. Results. Thirteen papers were included in the final review. Themes identified were: mechanism of disruption; reframing the mother role; protecting the children; experiencing guilt or shame; problems with healthcare professionals; and living to mother, mothering to live. Conclusion. Women disrupted in their mothering by illness view themselves as a mother first and a patient second. Women found themselves unsupported in their mothering role by healthcare professionals, and this may have left them reluctant to broach difficulties they had relinquishing mothering duties when ill. Nurses are well-positioned to support women in illness by acknowledging the importance of their identity as mothers, offering them opportunities to discuss how illness is disrupting their ability to mother, providing support to help them negotiate the social/emotional distress experienced when mothering is disrupted and, where necessary, referring them to other members of the healthcare team, such as social workers.