Assessment of guidelines for good practice in psychosocial care of mothers after stillbirth: a cohort study

Hughes, Patricia; Turton, P; Hopper, Earl; Evans, Chris

doi:10.1016/s0140-6736(02)09410-2

Cited by 238 publications

(148 citation statements)

References 23 publications

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“…Our finding that holding the stillborn baby is protective for a high PTSS level in the long term supports the general opinion that contact with the baby is beneficial, even though it has been speculated that this effect may be temporarily reversed during a subsequent pregnancy. 14 16 Rådestad and Christoffersen 32 have previously suggested that one reason for the findings by Hughes et al 16 that holding the stillborn baby increases psychological morbidity could be that the women were not sufficiently prepared for this contact. Even though contact with the baby seems to have a positive effect in our study, it is possible that a forced encounter could be potentially traumatic for a subgroup of women who do not want this contact.…”

Section: Discussionmentioning

confidence: 99%

Women's experiences in relation to stillbirth and risk factors for long-term post-traumatic stress symptoms: a retrospective study

et al. 2013

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Objectives(1) To investigate the experiences of women with a previous stillbirth and their appraisal of the care they received at the hospital. (2) To assess the long-term level of post-traumatic stress symptoms (PTSS) in this group and identify risk factors for this outcome.DesignA retrospective study.SettingTwo university hospitals.ParticipantsThe study population comprised 379 women with a verified diagnosis of stillbirth (≥23 gestational weeks or birth weight ≥500 g) in a singleton or twin pregnancy 5–18 years previously. 101 women completed a comprehensive questionnaire in two parts.Primary and secondary outcome measuresThe women's experiences and appraisal of the care provided by healthcare professionals before, during and after stillbirth. PTSS at follow-up was assessed using the Impact of Event Scale (IES).ResultsThe great majority saw (98%) and held (82%) their baby. Most women felt that healthcare professionals were supportive during the delivery (85.6%) and showed respect towards their baby (94.9%). The majority (91.1%) had received some form of short-term follow-up. One-third showed clinically significant long-term PTSS (IES ≥ 20). Independent risk factors were younger age (OR 6.60, 95% CI 1.99 to 21.83), induced abortion prior to stillbirth (OR 5.78, 95% CI 1.56 to 21.38) and higher parity (OR 3.46, 95% CI 1.19 to 10.07) at the time of stillbirth. Having held the baby (OR 0.17, 95% CI 0.05 to 0.56) was associated with less PTSS.ConclusionsThe great majority saw and held their baby and were satisfied with the support from healthcare professionals. One in three women presented with a clinically significant level of PTSS 5–18 years after stillbirth. Having held the baby was protective, whereas prior induced abortion was a risk factor for a high level of PTSS.Trial registrationThe study was registered at http://www.clinicaltrials.gov, with registration number NCT 00856076.

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Section: Discussionmentioning

confidence: 99%

Women's experiences in relation to stillbirth and risk factors for long-term post-traumatic stress symptoms: a retrospective study

et al. 2013

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“…Stillbirth encompasses several dimensions of loss: loss of the creation of a new life, loss of a dream and of the future, loss of self-identity, and loss of anticipated parenthood (Callister, 2006;Downe, Schmidt, Kingdon, & Heazell, 2013;McCreight, 2008). Grief reactions include shock, guilt, blame, anger and hostility, tears, and somatic complaints (Bennett, Litz, Maguen, & Ehrenreich, 2008;Côté-Arsenault, 2003a;Hughes, Turton, Hopper, & Evans, 2002;Lang et al, 2011;Radestad, 2001;Shaefer, 2010). Adjusting to perinatal death is difficult because the death is sudden and unexpected, there are no memories or experiences to share, many mothers of stillborn children do not see their deceased child and therefore have no concrete object to mourn, and societal expectations for mourning this type of loss are absent (Callister, 2006;Gaudet, 2010;Lee & Slade, 1996;Robinson, Stirtzinger, Stewart, & Ralevski, 1994;Worden, 2009).…”

Section: Grief and Recovery After Stillbirthmentioning

confidence: 99%

Taiwanese Women's Process of Recovery From Stillbirth: A Qualitative Descriptive Study

Tseng

Chen

Wang

2014

Research in Nursing & Health

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The purpose of this qualitative descriptive study was to portray the recovery process of Taiwanese women after stillbirth. Data were generated through individual in-depth interviews with 21 women selected using purposeful sampling. Three stages in an emotional journey of recovery were suffering from silent grief, searching for a way out, and achieving peace of mind and mental stability. Throughout their journey, the women's overarching concern was where the deceased child had gone and whether it was well. Together these stages composed A pathway to peace of mind, a mental journey on which women struggled to spiritually connect with the lost baby and finally sought a personal pathway to emotional peace. Findings can inform healthcare providers in providing culturally sensitive care for Taiwanese women to facilitate healing after a stillbirth.

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“…8 Qualitative studies have found that parents feel holding the stillborn baby is a valuable and important opportunity to build memories, 'say goodbye' and generate mementoes. 5 12-14 In contrast, quantitative findings have been mixed, with studies finding negative, [15][16][17] positive 18 and null or mixed effects on mental health. 19 20 A recent systematic review identified 11 quantitative studies comparing outcomes Strengths and limitations of this study ▪ The study used data from a population-based sample of women, but the low response rate may have biased findings.…”

Section: Introductionmentioning

confidence: 99%

Impact of holding the baby following stillbirth on maternal mental health and well-being: findings from a national survey

2016

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ObjectivesTo compare mental health and well-being outcomes at 3 and 9 months after the stillbirth among women who held or did not hold their baby, adjusting for demographic and clinical differences.DesignSecondary analyses of data from a postal population survey.PopulationWomen with a registered stillbirth in England in 2012.Methods468 eligible responses were compared. Differences in demographic, clinical and care characteristics between those who held or did not hold their infant were described and adjusted for in subsequent analysis. Mental health and well-being outcomes were compared, and subgroup comparisons tested hypothesised moderating factors.Outcome MeasuresSelf-reported depression, anxiety, post-traumatic stress disorder (PTSD) symptoms and relationship difficulties.ResultsThere was a 30.2% response rate to the survey. Most women saw (97%, n=434) and held (84%, n=394) their baby after stillbirth. There were some demographic differences with migrant women, women who had a multiple birth and those whose pregnancy resulted from fertility treatment being less likely to hold their baby. Women who held their stillborn baby consistently reported higher rates of mental health and relationship difficulties. After adjustment, women who held their baby had 2.12 times higher odds (95% CI 1.11 to 4.04) of reporting anxiety at 9 months and 5.33 times higher odds (95% CI 1.26 to 22.53) of reporting relationship difficulties with family. Some evidence for proposed moderators was observed with poorer mental health reported by women who had held a stillborn baby of <33 weeks’ gestation, and those pregnant at outcome assessment.ConclusionsThis study supports concern about the negative impact of holding the infant after stillbirth. Results are limited by the observational nature of the study, survey response rate and inability to adjust for women's baseline anxiety. Findings add important evidence to a mixed body of literature.

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Assessment of guidelines for good practice in psychosocial care of mothers after stillbirth: a cohort study

Cited by 238 publications

References 23 publications

Women's experiences in relation to stillbirth and risk factors for long-term post-traumatic stress symptoms: a retrospective study

Women's experiences in relation to stillbirth and risk factors for long-term post-traumatic stress symptoms: a retrospective study

Taiwanese Women's Process of Recovery From Stillbirth: A Qualitative Descriptive Study

Impact of holding the baby following stillbirth on maternal mental health and well-being: findings from a national survey

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