Is care of stillborn babies and their parents respectful? Results from an international online survey

Abstract

Objective To quantify parents’ experiences of respectful care around stillbirth globally. Design Multi-country, online, cross-sectional survey. Setting and Population Self-identified bereaved parents (n=3769) of stillborn babies from 44 high- and middle-income countries. Methods Parents’ perspectives of 7 aspects of care quality, factors associated with respectful care, and 7 bereavement care practices were compared across geographical regions using descriptive statistics. Respectful care was compared between country income groups using multivariable logistic regression. Main Outcome Measures Self-reported experience of care around the time of stillbirth Results A quarter (25.4%) of 3769 respondents reported disrespectful care after stillbirth and 23.5% reported disrespectful care of their baby. Gestation <30 weeks, and primiparity were associated with disrespect. Reported respectful care was lower in middle-income countries (MICs) than in high-income countries (HICs) (aOR=0.35, 95%CI (0.29-0.42), p <0.01). In many countries, aspects of care quality need improvement, such as ensuring families have enough time with providers. Participating respondents from Latin America and Southern Europe reported lower satisfaction across all aspects of care quality compared to Northern Europe. Unmet need for memory-making activities in MICs is high. Conclusions Despite improvements, many parents still experience disrespectful care around stillbirth. The gap between parents’ access to memory-making activities in MICs and HICs needs urgent attention. Tweetable abstract A quarter of parents of stillborn babies experience disrespectful care. There is global unmet need for memory-making activities

Effectiveness of the implementation of a perinatal bereavement care training programme on nurses and midwives: protocol for a mixed-method study

“…Despite recent medical advances, disrespectful care was still described by parents in perinatal bereavement practice 10. This suggests that nurses and midwives need to receive relevant trainings so that they can be fully prepared to provide high-quality perinatal bereavement care for parents.…”

“…However, the reality was that women’s experiences of clinical care did not meet their expectations 7 9. Disrespectful care of parents and infants was reported 10…”

“…They do not know how to communicate with the women and their families 26 27. Nurses and midwives also described feelings of powerlessness regarding pain management 10 28. Moreover, a scoping review indicated that perinatal death had a profound influence on the psychological well-being of healthcare professionals 29.…”