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- 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- and middle-income countries. Differences in proportions of reported practices and their associated odds ratios were calculated to compare high- and middle-income countries.
Results
Over three-thousand parents (3041) with a self-reported stillbirth in the preceding five years from 40 countries responded. At least 40 responses came from 15 countries.
Significant differences in 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). 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.
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- 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- and middle-income countries. Differences in proportions of reported practices and their associated odds ratios were calculated to compare high- and middle-income countries.
Results
Over three-thousand parents (3041) with a self-reported stillbirth in the preceding five years from 40 countries responded. At least 40 responses came from 15 countries.
Significant differences in 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). 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.
| Original language | English |
|---|---|
| Journal | Birth |
| Publication status | Accepted/In press - 25 Feb 2021 |
