Temporal Themes in Periviable Birth: A Qualitative Analysis of Patient Experiences

  • Tara A. LynchEmail author
  • Melissa Cheyney
  • Meredith Chan
  • Jennifer Walia
  • Paul Burcher


Objective Periviable birth accounts for a very small percentage of preterm deliveries but a large proportion of perinatal and neonatal morbidity. Understanding parental experiences during and after periviable deliveries may help healthcare providers determine how to best support women during these medically complex, emotionally charged clinical encounters. Methods This is a qualitative study with a voluntary sample of women who delivered between 22 and 25 weeks gestation at an academic medical center from 2014 to 2016. Women’s narratives of each periviable birth experience were transcribed and analyzed using consensus coding and a grounded theory approach to identify key themes that describe parental experiences. Results A total of 10 women were interviewed. Four emergent temporal themes: (1) the time preceding admission: feeling dismissed; (2) transfer or admission to a tertiary care center: anxiety and doubt; (3) the birth itself: fear of the outcome; and (4) the postpartum period: reflection and communication. Conclusions for practice Women that experience a periviable birth may benefit from continuous support and clear communication. Overall, care for these patients should be expanded to address the specific psychosocial needs identified during the distinctive, periviable temporal themes that emerged during interviews. Continuous longitudinal support in the form of a designated person or team should be provided to women experiencing a potential periviable birth in order to help mitigate the fear and anxiety associated with these complex birth experiences.


Communication Periviable birth Parental experiences Temporal themes 



We would like to thank the women who so generously shared their stories with us even in a time of great familial and personal crisis.

Compliance with Ethical Standards

Conflict of interest

The authors report no conflict of interest or financial support. This study was approved by the Institutional Review Board prior to initiation.

Supplementary material

10995_2018_2727_MOESM1_ESM.docx (14 kb)
Supplementary material 1 (DOCX 14 KB)


  1. Bohren, M. A., Hofmeyr, G. J., Sakala, C., Fukuzawa, R. K., & Cuthbert, A. (2017). Continuous support for women during childbirth. The Cochrane Database of Systematic Reviews, 7, CD003766. Scholar
  2. Burcher, P., Cheyney, M. J., Li, K. N., Hushmendy, S., & Kiley, K. C. (2016). Cesarean birth regret and dissatisfaction: A qualitative approach. Birth. Scholar
  3. Caeymaex, L., Speranza, M., Vasilescu, C., Danan, C., Bourrat, M. M., Garel, M., et al. (2011). Living with a crucial decision: A qualitative study of parental narratives three years after the loss of their newborn in the NICU. PLoS ONE, 6(12), e28633. Scholar
  4. Callister, L. C. (2004). Making meaning: Women’s birth narratives. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 33(4), 508–518.CrossRefGoogle Scholar
  5. Callister, L. C. (2006). Perinatal loss: A family perspective. Journal of Perinatal and Neonatal Nursing, 20(3), 227–234. quiz 235 – 226.CrossRefGoogle Scholar
  6. Campo-Engelstein, L. (2012). Competing social norms: Why women are responsible for but not trusted with contraception. International Journal of Applied Philosophy, 26(1), 66–84.CrossRefGoogle Scholar
  7. Charmaz, K. (2014). Constructing grounded theory. Introducing qualitative methods series (2nd ed.). London: Sage.Google Scholar
  8. Cohen, D., & Crabtree, B. (July 2006). Qualitative Research Guidelines Project. Retrieved from
  9. Greene, M. M., Rossman, B., Patra, K., Kratovil, A. L., Janes, J. E., & Meier, P. P. (2015). Depression, anxiety, and perinatal-specific posttraumatic distress in mothers of very low birth weight infants in the neonatal intensive care unit. Journal of Developmental & Behavioral Pediatrics, 36(5), 362–370. Scholar
  10. Grobman, W. A., Kavanaugh, K., Moro, T., DeRegnier, R. A., & Savage, T. (2010). Providing advice to parents for women at acutely high risk of periviable delivery. Obstetrics & Gynecology, 115(5), 904–909. Scholar
  11. Holloway, I. (1997). Basic concepts for qualitative research. London: Blackwell.Google Scholar
  12. Horwitz, S. M., Leibovitz, A., Lilo, E., Jo, B., Debattista, A., St John, N., et al. (2015). Does an intervention to reduce maternal anxiety, depression and trauma also improve mothers’ perceptions of their preterm infants’ vulnerability? The Infant Mental Health Journal, 36(1), 42–52. Scholar
  13. Jubinville, J., Newburn-Cook, C., Hegadoren, K., & Lacaze-Masmonteil, T. (2012). Symptoms of acute stress disorder in mothers of premature infants. Advances in Neonatal Care, 12(4), 246–253. Scholar
  14. Lau, C., Ambalavanan, N., Chakraborty, H., Wingate, M. S., & Carlo, W. A. (2013). Extremely low birth weight and infant mortality rates in the United States. Pediatrics, 131(5), 855–860. Scholar
  15. Lynch, T., & Burcher, P. (2016). Periviability: Translating informed assent and non-dissent to obstetrics. Ethics and Medicine, 31(1), 31–38.Google Scholar
  16. Martin, J. A., Hamilton, B. E., & Osterman, M. J. (2016). Births in the United States, 2015. NCHS Data Brief, 258, 1–8.Google Scholar
  17. Misund, A. R., Nerdrum, P., Braten, S., Pripp, A. H., & Diseth, T. H. (2013). Long-term risk of mental health problems in women experiencing preterm birth: A longitudinal study of 29 mothers. Annals of General Psychiatry, 12(1), 33. Scholar
  18. Peters, M. D., Lisy, K., Riitano, D., Jordan, Z., & Aromataris, E. (2016). Providing meaningful care for families experiencing stillbirth: A meta-synthesis of qualitative evidence. Journal of Perinatology, 36(1), 3–9. Scholar
  19. Raymond, J. G. (1990). Reproductive gifts and gift giving: The altruistic woman. Hastings Center Report, 20(6), 7–11.CrossRefGoogle Scholar
  20. Rothman, B. K. (1993). The tentative pregnancy: Then and now. Fetal Diagnosis and Therapy, 8(Suppl 1), 60–63.CrossRefGoogle Scholar
  21. Sawyer, A., Rabe, H., Abbott, J., Gyte, G., Duley, L., & Ayers, S. (2013). Parents’ experiences and satisfaction with care during the birth of their very preterm baby: A qualitative study. BJOG, 120(5), 637–643. Scholar
  22. Shaw, E., Levitt, C., Wong, S., & Kaczorowski, J. (2006). Systematic review of the literature on postpartum care: Effectiveness of postpartum support to improve maternal parenting, mental health, quality of life, and physical health. Birth, 33(3), 210–220. Scholar
  23. Tucker Edmonds, B., Savage, T. A., Kimura, R. E., Kilpatrick, S. J., Kuppermann, M., Grobman, W., et al. (2017). Prospective parents’ perspectives on antenatal decision making for the anticipated birth of a periviable infant. Journal of Maternal-Fetal & Neonatal Medicine. Scholar
  24. Vigod, S. N., Villegas, L., Dennis, C. L., & Ross, L. E. (2010). Prevalence and risk factors for postpartum depression among women with preterm and low-birth-weight infants: A systematic review. BJOG, 117(5), 540–550. Scholar
  25. Younge, N., Goldstein, R. F., Bann, C. M., Hintz, S. R., Patel, R. M., Smith, P. B., … Cotten, C. M. (2017). Survival and neurodevelopmental outcomes among periviable infants. New England Journal of Medicine, 376(7), 617–628.

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Tara A. Lynch
    • 1
    Email author
  • Melissa Cheyney
    • 2
  • Meredith Chan
    • 1
  • Jennifer Walia
    • 1
  • Paul Burcher
    • 3
  1. 1.Department of Obstetrics and GynecologyAlbany Medical CenterAlbanyUSA
  2. 2.Department of AnthropologyOregon State UniversityCorvalisUSA
  3. 3.Department of Bioethics and Obstetrics and GynecologyAlbany Medical CenterAlbanyUSA

Personalised recommendations