Maternal appraisal of information given around the time of preterm delivery

Abstract

This study addressed the extent to which mothers recall and understand information given to them at the time of preterm delivery of an infant at high risk and requiring neonatal intensive care. Mothers of 76 preterm babies were interviewed at 6 weeks post notional term, 46 weeks post menstrual age, using a semi-structured interview format. The babies had a median birthweight of 1,190 g and a median gestational age of 28 weeks. Approximately half were delivered vaginally, and half by caesarean section. In approximately half of the sample, cerebral lesions considered to be likely to lead to cerebral palsy had been identified by ultrasound scan. Mothers' responses to the interview were coded to indicate their degree of recall and understanding of information, and their feelings at the time. Their predictions for their babies were also elicited. Maternal depression was assessed. The mothers' recall and understanding often appeared limited, and their predictions for the future did not reflect diagnosis. The majority had considerable negative feelings about the birth. Delivery type appeared to have little or no impact on response. Maternal depression seen in 18 mothers did not appear to influence recall or understanding, although there were indications that depression did affect satisfaction with the information given by professionals. Further work is needed to ensure that parental cognitive coping strategies in the face of an overwhelming experience are understood so that parents are supported appropriately in coping with their experiences and planning for the future.