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

Este artículo es resultado de una investigación internacional iniciado por miembros de International Stillbirth Alliance. Umamanita participó en el diseño de estudio, su traslación al contexto español y en la organización del trabajo de campo. Los resultados del estudio se centran en una comparación de las practicas en la atención al duelo perinatal entre países y regiones. Desde el punto de vista de España, el resultado más notable es una confirmación que queda muy atrás en las practicas recomendadas en comparación con otros países de renta alta. El estudio encontró un resultado muy similar para los países de sur y central America y Mexico. Se puede leer el resumen (en inglés) más abajo.

El artículo fue publicado en la revista Birth

Doi: https://doi.org/10.1111/birt.12546

Autores: Dell Horey PhD, MMedSc(Clin, Epi); Frances M. Boyle BA (Psych Hons), PhD; Jillian Cassidy; Paul Richard Cassidy BBS, MPhil; Jan Jaap H. M. Erwich MD, PhD, Katherine J. Gold MD, MSW, MS; Mechthild M. Gross PhD; Alexander E. P. Heazell MBChB(Hons), PhD, MRCOG; Susannah Hopkins Leisher MSc; Margaret Murphy Doctor of Nursing, MSc, BSc, RM, RGN, IBCLC; Claudia Ravaldi MD, MSc; Dimitrios Siassakos MRCOG, MD (Clinical Research), MSc (London), DLSHTM, PGDip (MedEduc); Claire Storey BA; Alfredo Vannacci MD, PhD; Aleena Wojcieszek PhD; Vicki Flenady PhD

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.