Parents' experience of the care they received following a stillbirth: a literature review

Headnote

Abstract

Background. Stillbirth can be considered by both midwives and families as a highly emotive yet almost invisible topic that is often not fully explored or discussed.

Aim. This paper focuses mainly on primary, qualitative research that demonstrates the lived experience of parents who have endured a stillbirth. The intention was to gain an understanding of what parents perceived as good practice, in order to inform future recommendations for clinical practice.

Method. Platform host Ebscohost was used to search electronically across the following databases: Embase, Global Health, Journals from Ovid, Maternity and Infant Care, MEDLINE, CINAHL Plus with text, Science Direct, British Nursing Index, The Cochrane Central Register of Controlled Trials, e-journals; PsycINFO, Psychology and Behavioral Sciences. Key words included 'stillbirth experience & parents', 'stillbirth & memories', 'stillbirth & care', 'stillbirth & midwives','stillbirth & fathers'. A total of 45 papers were found and screened for relevance and appropriateness, 20 were selected based on the emerging themes and eight papers met the criteria and were included for review.

Findings. Most women reported a dearth of information during their first encounter with the health service. Fathers felt they were often excluded during communication and information-giving. A woman's psychological health was negatively affected when induction was delayed for more than 24 hours after the diagnosis of fetal death. Parents valued the obtaining of mementos and being offered choice and informative support about meeting their stillborn baby.

Recommendations. Optimal timing of induction and appropriate preparation for vaginal birth and meeting the baby are also important, as is ensuring the provision of high-quality mementos.

Conclusion. Effective sensitive communication, individualised care and guidance from health professionals in making informed choices about meeting and remembering the child were vital in reducing parents' trauma associated with stillbirth.

Key words: Stillbirth, parents' experience, memories, care, bereavement, evidence-based midwifery

Introduction

The definition of a stillbirth, according to the RCOG, is: 'Any child expelled or issued forth from its mother after the 24th week of pregnancy that did not breathe or show any other signs of life' (RCOG, 2010: 20).

Unfortunately, stillbirth is not a rare occurrence. In the UK around 10 babies are stillborn every day (Sands, 2016). A series of reports in The Lancet (Lawn et al, 2011) pertaining to stillbirth, recorded that...