Parents’ experiences of care offered after stillbirth: An international online survey of high and middle‐income countries

Abstract

Background Stillbirth, the death of a baby before birth, is associated with significant psychological and social consequences that can be mitigated by respectful and supportive bereavement care. The absence of high‐level evidence to support the broad scope of perinatal bereavement practices means that offering a range of options identified as valued by parents has become an important indicator of care quality. This study aimed to describe bereavement care practices offered to parents across different high‐income and middle‐income countries. Methods An online survey of parents of stillborn babies was conducted between December 2014 and February 2015. Frequencies of nine practices were compared between high‐income and middle‐income countries. Differences in proportions of reported practices and their associated odds ratios were calculated to compare high‐income and middle‐income countries. Results Over three thousand parents (3041) with a self‐reported stillbirth in the preceding five years from 40 countries responded. Fifteen countries had atleast 40 responses. Significant differences in the prevalence of offering nine bereavement care practices were reported by women in high‐income countries (HICs) compared with women in middle‐income countries (MICs). All nine practices were reported to occur significantly more frequently by women in HICs, including opportunity to see and hold their baby (OR = 4.8, 95% CI 4.0‐5.9). The widespread occurrence of all nine practices was reported only for The Netherlands. Conclusions Bereavement care after stillbirth varies between countries. Future research should look at why these differences occur, their impact on parents, and whether differences should be addressed, particularly how to support effective communication, decision‐making, and follow‐up care.

Is care of stillborn babies and their parents respectful? Results from an international online survey

“…Other analyses of these data have been published; one which triangulated the perspectives of parents, care providers, and community members 17 ; and one which explored parents' experiences in subsequent pregnancies 18 . These data have also been used in analyses that compare high‐income countries (HICs) and middle‐income countries (MICs) 10,19 . These show the variability in parents' experiences after stillbirth and describe where bereavement care practices are offered to parents.…”

Multicountry study protocol of COCOON: COntinuing Care in COVID-19 Outbreak global survey of New, expectant, and bereaved parent experiences

“…The bereavement-specific surveys (E, F, G, H) also include questions to understand the experiences of care offered to parents following stillbirth or neonatal death. 24 This section also includes several open-text fields for further information.…”

“…It is particularly important to understand bereaved parent experiences of care during this time, and the extent to which recommended perinatal bereavement care practices—which are known to vary widely between countries even in non-pandemic times—are being provided. 24 26 …”

Parents’ experiences of care offered after stillbirth: available, accessible, acceptable, equitable and effective care

“…Horey et al conducted the Multilanguage online survey of parents who had stillborn babies between December 2014 and February 2015. The survey drew on domains of the PSANZ/CRE framework,3 linked to nine components of bereavement care practices 3…”