Bereaved parents’ experience of stillbirth in UK hospitals: a qualitative interview study

Abstract

ObjectiveTo obtain the views of bereaved parents about their interactions with healthcare staff when their baby died just before or during labour.DesignQualitative in-depth interview study, following an earlier national survey. All interviews took place during 2011, either face-to-face or on the telephone. Data analysis was informed by the constant comparative technique from grounded theory.SettingEvery National Health Service (NHS) region in the UK was represented.ParticipantsBereaved parents who had completed an e-questionnaire, via the website of Sands (Stillbirth and Neonatal Death Society). Of the 304 survey respondents who gave provisional consent, 29 families were approached to take part, based on maximum variation sampling and data saturation.Results22 families (n=25) participated. Births took place between 2002 and 2010. Specific practices were identified that were particularly helpful to the parents. Respondents talked about their interactions with hospital staff as having profound effects on their capacity to cope, both during labour and in the longer term. The data generated three key themes: ‘enduring and multiple loss’: ‘making irretrievable moments precious’; and the ‘best care possible to the worst imaginable’. The overall synthesis of findings is encapsulated in the meta-theme ‘One chance to get it right.’ This pertains to the parents and family themselves, clinical and support staff who care for them directly, and the NHS organisations that indirectly provide the resources and governance procedures that may (or may not) foster a caring ethos.ConclusionsPositive memories and outcomes following stillbirth depend as much on genuinely caring staff attitudes and behaviours as on high-quality clinical procedures. All staff who encounter parents in this situation need to see each meeting as their one chance to get it right.

Exploring perinatal death with midwifery students' using a collaborative art project

“…The letter from the midwife that was kept by the woman as her amulet resonated with all the students and made them reflect on the role of the midwife from a personal and professional perspective. Downe et al (2013) conclude that the development of caring behaviour and empathetic engagement needs to be fostered through affective learning. Educators need to ensure that a wide range of learning strategies are used when preparing students for perinatal bereavement care.…”

“…Downe et al (2013) emphasise that everyone involved in the care of parents experiencing stillbirth has only one opportunity to do the right thing, and that parental recovery is greatly affected by the attitude and caring behaviours of staff. In a national review of support available for loss in early and late pregnancy it was found that midwifery students are generally protected from caring for women experiencing loss, and this could impact on their skills and confidence when qualified (Ottley et al, 2014).…”

“…Kelley Trinidad (2012, p7) reported that for bereaved parents the most profound aspect of care occurred when obstetricians and midwives assigned time 'to sit with them look them in the eye and be present with them in their sadness'. As Downe et al (2013) study shows it can be deeply upsetting for parents when their needs are not met at this time. Papadatou (2009) views relational care as the unique reciprocal influence that exists between the professional and the bereaved parents, and that an integral aspect of the care process is bringing something personal that transcends knowledge and skills.…”

“…Bereavement is part of life, and bereavement and death associated with stillbirth is recognised as a time when there may be only one chance to get it right (Downe et al, 2013). As Schott and Henly (2007) emphasise, memories may be the only things that parents have to take home, and most of those memories will involve the care they receive.…”

“…Individualised care and the manner in which staff behaved was of key importance in a UK national survey of parents after stillbirth or the death of their baby (Redshaw et al, 2014). Downe et al (2013) in their study on bereaved parents' experience of stillbirth suggest that an ethos of care at all levels of the organisation is central to positive staff caring behaviours. Hospital policy and meeting training needs of staff has a positive effect on attitudes towards bereavement care, demonstrated by Chan et al (2004).…”