Perceived Stress, Quality of Life and Pregnancy Outcomes Among Women with Hypertensive Disorders of Pregnancy (HDP) And Role of Midwives in It: A Systematic Review

Abstract

Hypertensive disorders during pregnancy are one of the leading causes of maternal & newborn death across the world. Many of the hypertensive antenatal women often end of with admission to ICU due to severe pre-eclampsia and eclampsia, or delivering dead babies of term pregnancy, even if live baby delivered, they mostly admitted to NICU due to respiratory distress and prematurity. Hence, they need continuous educational intervention and follow up by healthcare personnel. And a midwife is the right person for this. Midwives play an important role in encouraging pregnant mothers to adhere to treatment through various education and follow up resulting in safe pregnancy outcome among these mothers. But in Indian scenario in many places the role of midwives are often ignored while managing pregnancy complications. Therefore, current paper aimed to explore the expanded role of midwives in identifying the affected quality of life and its impact on pregnancy outcome among women with HDPs. The empirical research papers of various countries were searched through the electronic databases like Pro-Quest, Embase, Research Gate, Science direct, PUBMED, MEDLINE, CINAHL-EBSCO, web of science, Google Scholar etc and the references were also searched of those primary articles. A total of 15 out of 275 studies including both RCTs, Systematic & narrative review papers were analysed. In this paper 4 relevant points were analyzed, like- perceived stress, quality of life (QOL), pregnancy outcomes and role of midwife in GHTN management in rural India. The research papers on pregnancy outcomes as well as stress and QOL secondary to gestational outcome were plenty, but very less studies were retrieved on role of midwives. Mother’s with GHTN has more stress regarding the fetal wellbeing which ultimately affects the quality of life. Interventional studies revealed reduction in stress and improved perinatal outcome secondary to some integrated midwifery management approach. More research on addressing quality of life and exploring the stressors and interventional programs by midwifes are recommended to bring solution to this problem. The result of this review can be incorporated into nursing research to empower the women with gestational hypertension to have a positive pregnancy experience.