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Item Care Experiences of Women Who Used Opioids and Experienced Fetal or Infant Loss(Elsevier, 2017-11) Scott, Lisa F.; Shieh, Carol; Umoren, Rachel A.; Conard, Teri; School of NursingObjective To explore care experiences of women who used prescription or illicit opioids and experienced fetal or infant loss. Design A qualitative, descriptive design with secondary data analysis. Setting The Fetal and Infant Mortality Review program in an urban Midwestern county in the United States. Participants Eleven women with histories of prescription or illicit opioid use who experienced fetal or infant loss participated in the semistructured telephone or in-person interview portion of the mortality case review. Methods We used thematic analysis to analyze interview data. Results Five themes were identified related to the care experiences of participants throughout pregnancy and fetal/infant loss: Frustration and anger related to not being heard, feeling minimalized; Being overwhelmed with attempts to process and understand medical complications and outcomes; Profound sense of grief and coping with loss; Need to understand why and make difficult decisions; and Placing blame and guilt over death. Conclusion Our findings suggest that women who use opioids and experience fetal or infant loss have complex care, educational, and emotional needs. In the development of interventions for these women, it is important to address their unique and complex circumstances.Item Experience of Maternal Narcotics Users with Fetal and Infant Loss throughout the Infant Life Cycle(Office of the Vice Chancellor for Research, 2016-04-08) Scott, Lisa Fath; Shieh, Carol; Umoren, Rachel A.; Conard, TeriObjective: Fetal or infant loss is a painful and traumatic experience for all mothers. Literature, however, has been limited in describing maternal experience from pregnancy to the time when a baby dies. This study explored the experience of mothers using prescribed or illicit opioids and encountering fetal or infant loss. Design: A qualitative approach using a reflexive iteration process was used to identify maternal experience across an infant’s life cycle. Participants: Eleven mothers (mostly white, single, less than a high school education) with a history of using prescribed or illicit opioids participated in the semi-structured telephone or in person maternal interview portion of the Fetal and Infant Mortality Review in a Midwest county. Methods: Interview transcripts were first coded. Codes with similar meaning were grouped into categories. Categories sharing similar features were collapsed into common themes. Each phase of analysis was performed and checked by three investigators. Results: Four common themes were identified throughout the entire life cycle of the infant: not being heard, dealing with medical complications, reproductive health, and grief, guilt and bereavement. Mothers perceived that their needs and concerns were not carefully attended to by care providers. They were overwhelmed by medical information about pregnancy and infant complications. Participants did not plan for the pregnancy or use contraception prior to the pregnancy but did use contraception in the post-partum period. Many mothers struggled with grief and loss. Additional themes included care needs for substance use and mental health and taking action and making decisions for the baby’s life. Conclusions: The findings suggest women experiencing opioid use have education and care needs when dealing with fetal/infant loss. When developing interventions for these women, clear communication about medical complications, emotional and bereavement support, and services to help these women prevent unplanned pregnancy are needed.