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All bereaved parents are entitled to good care after stillbirth: a mixed-methods multicentre study (INSIGHT)

Plain language summary from BJOG's Stillbirth themed issue
Read the full study

Why and how was the study carried out?

Previous studies have shown that improving care after stillbirth is important for families. We investigated the opinions of bereaved parents and maternity staff to find ways to improve care.

At three hospitals in 2013, all women who experienced a stillbirth were invited to an interview along with their partners. Thirty-five parents of 21 babies agreed to participate. Twenty-two obstetricians and midwives took part in focus group discussions.

What were the main findings?

  • Care was often not as good as it should and could be. Communication with parents was not always as sensitive as they would have liked because staff did not have appropriate training.
  • Some women reported they did not ‘feel right’ before going to hospital. Once they arrived, there was no standard approach to how care was given. Sometimes there were long delays before the death of the baby was confirmed and action was taken.
  • After it had been confirmed that the baby had died, staff focussed on the mothers’ needs, but the parents' priorities were still with their baby. There were several reasons why parents asked for a caesarean birth that staff had not considered.
  • Staff influenced parents' decisions about post-mortem examinations. Parents found it helpful when staff explained the respectful nature and purpose of the examination.
  • After discharge from hospital, there was no consistent plan for how follow-up care would be given. Parents would have liked more information about their next hospital appointment.

What are the limitations of the work?

The parents interviewed depended on their memories of the details of the care, which happened some time ago. In staff group discussions, junior doctors may not have spoken openly because there were senior doctors present. Further research is necessary to understand and improve care globally.

What is the implication for parents?

Every bereaved parent is entitled to the best possible care after stillbirth, but some do not get good care. Parents and staff made suggestions that can help to develop processes for how care is given after stillbirth. These suggestions can also inform staff training, so that every single parent is treated respectfully and participates in decision making.

Reproduced from: Siassakos D, Jackson S, Gleeson K, Chebsey C, Ellis A, Storey C for the INSIGHT Study Group. All bereaved parents are entitled to good care after stillbirth: a mixed-methods multicentre study (INSIGHT). BJOG 2018;125:160–170;