Parents' Experiences About Support Following Stillbirth and Neonatal Death

Abstract

Background: Stillbirth and neonatal death are one of the most stressful life events, with negative outcomes for parents. Society does not recognize this type of loss, and parental grieving is particularly complicated and intense. Purpose: The aim of this study was to describe and understand the experiences of parents in relation to professional and social support following stillbirth and neonatal death. Methods: This was a qualitative study based on Gadamer's hermeneutic phenomenology. Twenty-one semistructured interviews were carried out. Inductive analysis was used to find themes based on the data. Results: Twenty-one parents (13 mothers and 8 fathers) from 6 families participated in the study. The analysis identified 2 main themes: (1) “professional care in dealing with parents' grief,” with the subthemes “important aspects of professional care,” “continuing of pathways of care”; and (2) “effects of social support in parental grief,” including the subthemes “the silence that surrounds grieving parents,” “family and other children: a key element,” and “perinatal loss support groups: a reciprocal help.” Implications for Practice: Counseling and support according to parents' requirements by an interdisciplinary team of professionals educated in perinatal loss and ethical family-centered care is needed. A social support system for families is necessary to avoid negative emotional consequences. Implications for Research: Further research is needed to analyze midwives' and nurses' experience as facilitators to improve parental grief and the difficulties experienced by the family, other children, and friends of parents with perinatal loss in providing support.

Integrative Review of Emotional Care Following Perinatal Loss

“…Numerous factors contribute to increase the risk of complicated grief in perinatal loss, such as the unexpected and sudden circumstances of the perinatal death, the lack of memories of the baby’s existence, and the self-blame for the pregnancy loss (Camacho-Ávila et al, 2020). In a descriptive cross-sectional, correctional study in Spain by Druguet et al (2018), the researchers concluded that intensity of grief was not determined by the period of the pregnancy at which the loss occurred, previous miscarriages, the presence of living children, the survival of one of the twins, or any of the sociodemographic variables examined.…”

“…The phenomenological qualitative study carried out by Meaney, Corcoran, Spillane, et al (2017) about the experience of miscarriage indicates that this experience has a considerable impact on men and women, and the participants stated that it was important the acknowledgment of the loss by health professionals and more broadly throughout society. However, perinatal or neonatal losses are not socially recognized or viewed as a significant problem, for this reason, the grieving may not be recognized openly, there may not be public grief or be socially accepted (Al-Maharma et al, 2016; Camacho-Ávila et al, 2020). As shown in one qualitative study based on the Gadamer’s hermeneutic phenomenology (Camacho-Ávila et al, 2020), the feeling of biological failure and shame experienced by the mothers made them feel socially stigmatized and avoid contact with other people in their surroundings.…”

“…However, perinatal or neonatal losses are not socially recognized or viewed as a significant problem, for this reason, the grieving may not be recognized openly, there may not be public grief or be socially accepted (Al-Maharma et al, 2016; Camacho-Ávila et al, 2020). As shown in one qualitative study based on the Gadamer’s hermeneutic phenomenology (Camacho-Ávila et al, 2020), the feeling of biological failure and shame experienced by the mothers made them feel socially stigmatized and avoid contact with other people in their surroundings. Complexity of perinatal grief in comparison to other types of grieving can lead to complicated or intense grief; these are lived in loneliness and silence (Videbeck, 2013).…”

“…Another qualitative study based on Gadamer’s hermeneutic phenomenology carried out in Spain (Camacho-Ávila et al, 2020) indicates that death in Western culture is often a taboo subject and speaking about it generally causes discomfort. Supporting the idea of the silence surrounding the perinatal loss, the cross-sectional study by Steen (2015) about bereavement interventions used by the U.S. and Spanish nurses and midwives to cope with perinatal death, Spanish nurses may be uncomfortable talking about the death because it is not openly discussed in society.…”

Impact of Perinatal Death on the Social and Family Context of the Parents

“…Worden included such environmental factors as "mediator 6: social variables" [36]. Although the individual implications of perinatal death on the parents [11][12][13][14][15][16][17][18] and the social support available to survivors [37] have been extensively investigated, there is a lack of research involving fathers [38,39]. Moreover, the impact of PD on the social environment and the extended family has been poorly investigated [40].…”