Bereaved parents involvement in maternity hospital perinatal death review processes: ‘Nobody even thought to ask us anything’

Abstract

Introduction The death of a baby is devastating for parents, families and staff involved. Involving bereaved parents in their baby's care and in the maternity hospital perinatal death review can help parents manage their bereavement and plan for the future. In Ireland, bereaved parents generally have not been involved in this review process. The aim of our study was to assess parents' perception of how they may be appropriately involved in the maternity hospital perinatal death review in ways that benefit them and the review process itself. Methods Bereaved parents ( n = 20) in Ireland were invited to take part in semistructured interviews. Thematic analysis was carried out on the interview transcripts. Results Four main themes were identified based on the participants' views and opinions on how they experienced the review process and how they feel this process may be improved. The themes reflect the journey of the parents through the different stages of the review process: Throughout process; On leaving the hospital; Interaction with the hospital ‘waiting in limbo’; Review itself. Identified subthemes highlighted essential aspects of this process and care provided to parents. For the parents, open, honest communication with staff, as well as having a key hospital contact was essential. Parents wished to provide feedback on their experience and wanted to be included in the review of their baby's death, in a way that was sensitive to their needs and the hospital's schedule. Conclusion A respectful, flexible system that allows bereaved parents' involvement in their baby's perinatal death review and is tailored to their needs is essential. A collaborative process between staff and parents can highlight clinical areas in need of change, enhance lessons learned, improve bereavement services and may prevent future perinatal deaths. Public Contribution Bereaved parents were interviewed for this study.

Midwives Perceptions on Perinatal Loss Care of Bereaved Mothers at KweKwe General Hospital, Zimbabwe

“…So I think many of us really need training to…see…although I don't feel maybe anything for that mother, but at least put yourself in that mother's shoes and at list help her professionally that's why l think training is the way to go'M7 ‗We do need training …I think it's a need…I think it's very necessary, we need to know and trained on how to do these things…'M3 Many health professionals recognise that they have insufficient knowledge and understanding of grief counselling to be insufficient, which is compounded by lack of targeted training when they encounter the occasion and need to counsel a bereaving mother during perinatal loss [43]. The development of basic and advanced education would enable staff to adequately cope with their work [44] which needs to be coupled with multi professional training and how to include parents [45] in this area for improvement of standards for bereavement care all round [46]. Participants expressed varied choices as they mentioned that some mothers preferred to be on their own alone in a room to deal with their grief while others preferred to be amongst people with the same predicament in order to share the experiences thereby facilitating coping.…”

“…Midwives may need to ask the parents whether they want to be alone, or to have family or a nurse stay with them; some young parents may be frightened because they have no previous experience with death [45].…”

“…Giving parent"s information and allowing them the time to consider the options empowers parents and enables them to be involved with decision making. Lack of information is perceived as an obstacle to parents" participation and control [45].…”

Educational workshops for health care professionals on compassionate communication following adverse events in health care: a mixed method evaluation

“…Within NHS Scotland, a serious adverse event review (SAER) is required following an event that could have caused (a near miss), or did result in, harm to people or groups of people [1]. Evidence on the bene ts of including patients and families in adverse event reviews is clear yet in practice this does not always happen [2,3,4]. A collaborative, person-centred approach which listens to, and involves, patients and their families is likely to lead to improved outcomes when things have gone wrong in healthcare.…”