Satisfaction with hospital care and interventions after pregnancy loss

Abstract

Hospital practices after pregnancy loss have changed considerably over the past decade, yet they have not been well evaluated. In a longitudinal study of 194 women and men who experienced miscarriage, ectopic pregnancy, stillbirth, or newborn death, the recommended interventions at the time of loss are examined. In most cases, parents were more satisfied if they had experienced an intervention than if they had not, but having experienced more total interventions was not associated with lower grief or greater satisfaction with overall care; the latter was related more to the attentiveness and sensitivity of health care personnel. Three groups identified as in need of greater attention are clinic patients, who were significantly less satisfied and more grief-stricken than the patients of private physicians, those who had spontaneous abortions or ectopic pregnancies, and those who had early fetal losses.

Navigating care after a baby dies: a systematic review of parent experiences with health providers

“…30 On the other hand, some reports were more favorable. Lasker and Toedter (1994) found 64% of parents very satisfied with the hospital staff, 36% satisfied and only 21% dissatisfied. 31 Similarly, Pector (2004) noted that parents who had infants in the Neonatal Intensive Care Unit (NICU) before death said 49% of staff remembered or acknowledged their loss and 76% reported they had been given support for their grief.…”

“…Lasker and Toedter (1994) found 64% of parents very satisfied with the hospital staff, 36% satisfied and only 21% dissatisfied. 31 Similarly, Pector (2004) noted that parents who had infants in the Neonatal Intensive Care Unit (NICU) before death said 49% of staff remembered or acknowledged their loss and 76% reported they had been given support for their grief. 32 In summary, parents had mixed experiences with their care providers with a high number expressing discomfort or dissatisfaction with specific interactions or insensitive behaviors and comments.…”

“…42 Several parents believed medical staff had minimized concerns expressed by the parents during pregnancy; the families believed that if they had been taken more seriously, their infant might have survived. 29,31,34,36 Several low-income parents reported that they had been treated unequally based on their finances. 17 As one mother lamented after her child died in the NICU, 'if I had a better insurance, they would have put their heart and soul into it and I feel they didn't.…”

“…16,18,38,44 Families also liked providers who they felt gave honest answers and appreciated health teams who provided them with consistent information, though parents often reported wanting even more information and explanations. 16,31,46 Finally, Wing (2002) described a perinatal grief program with multiple components and found, not surprisingly, that there was a correlation between the overall number of bereavement services given to parents and their general level of satisfaction with care. 46 In short, bereaved parents were most appreciative of actions that demonstrated emotional support from providers and showed attention to the physical needs of the mother and baby.…”

Some Comments on Parents Contacting with their Stillborn Baby

“…Psychosocial care began to change from the late 1970s to the 1990s in Sweden and the UK [1,2]. The guidelines recommend healthcare professionals to the grief of still born babies [3,4,5].…”