Holding a stillborn baby: the view from a specialist perinatal bereavement service

Aust N Z J Obstet Gynaecol. 2015 Aug;55(4):337-43. doi: 10.1111/ajo.12327. Epub 2015 Jun 30.

Abstract

Background: Stillbirth is a profoundly distressing event. Little evidence exists to guide best practice bereavement care in the perinatal setting.

Aims: To document parents' experiences and outcomes in relation to seeing and holding a stillborn baby at a hospital with a specialist perinatal bereavement service.

Materials and methods: Prospective cohort study of 26 mothers and 11 fathers who experienced a stillbirth at the Mater Mothers' Hospital, Brisbane from September 2007-December 2008. Mailed self-report questionnaires were completed at 6-8 weeks and 6 and 13 months postloss. Validated measures assessed regret regarding the decision to see and hold the baby, parental grief and mental health.

Results: Of 78 fetal deaths, 26 mothers and 11 fathers participated. Most (20 mothers; 9 fathers) chose to see and hold their stillborn infant. Little regret was reported, irrespective of the decision. For mothers, seeing and holding was associated with higher 'active grief' at 6-8 weeks (mean difference (MD) = 10.5; 95% CI = 3.3-17.8; P < 0.01), 6 months (MD = 8.0; 95% CI = 0.6-15.4; P = 0.03) and 13 months (MD = 9.9; 95% CI = 1.8-17.9; P = 0.01), but not with 'not coping' or 'despair', or mental health. Fathers reported poorer mental health but small numbers mean estimates are imprecise.

Conclusions: More intense grief does not equate with poorer mental health for mothers who choose to see and hold a stillborn infant. Fathers' experiences warrant further study. Supported decision-making is important for bereaved parents, and rigorous evaluation of bereavement care is essential.

Keywords: bereavement; delivery of health care; perinatal loss; pregnancy outcome; stillbirth.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Fathers / psychology*
  • Female
  • Follow-Up Studies
  • Grief*
  • Humans
  • Male
  • Mothers / psychology*
  • Patient Satisfaction / statistics & numerical data
  • Perinatal Care / methods*
  • Pregnancy
  • Prospective Studies
  • Self Report
  • Stillbirth / psychology*
  • Young Adult