Parental grief and relationships after the loss of a stillborn baby.

OBJECTIVES: to describe the grief of mothers and fathers and its influence on their relationships after the loss of a stillborn baby. DESIGN: a postal questionnaire at three months, one year and two years after stillbirth. SETTING: a study of mothers and fathers of babies stillborn during a one-year period in the Stockholm region of Sweden. PARTICIPANTS: 55 parents, 33 mothers and 22 fathers. FINDINGS: mothers and fathers stated that they became closer after the loss, and that the feeling deepened over the course of the following year. The parents said that they began grieving immediately as a gradual process, both as individuals, and together as a couple. During this grieving process their expectations, expressions and personal and joint needs might have threatened their relationship as a couple, in that they individually felt alone at this time of withdrawal. While some mothers and fathers had similar grieving styles, the intensity and expression of grief varied, and the effects were profound and unique for each individual. KEY CONCLUSIONS: experiences following a loss are complex, with each partner attempting to come to terms with the loss and the resultant effect on the relationship with their partner. IMPLICATIONS FOR PRACTICE: anticipating and being able to acknowledge the different aspects of grief will enable professionals to implement more effective intervention in helping couples grieve both individually and together.

Support after stillbirth and its effect on parental grief over time.

In this study the authors describe parents' experiences of support over a 2-year period after a stillbirth and its effect on parental grief. Data was collected by questionnaire from 33 mothers and 22 fathers at 3 months, 1 year, and 2 years after a stillbirth. Midwives, physicians, counselors, and priests--at the hospital where the stillbirth occurred--are those on the front line providing professional support. The support from family and friends was seen to be important 2 years after the stillbirth. The need for professional support after stillbirth can differ, depending on the support provided by family, friends, and social networks. They may not fully realize the value of their support and how to be supportive. Printed educational materials given to individuals in the social network or family might therefore be helpful.

Advice given by health-care professionals to mothers concerning subsequent pregnancy after stillbirth.

We studied the advice mothers with stillbirths were given concerning a suitable time to become pregnant. A questionnaire was sent in 2001 to mothers with a stillbirth at one of five hospitals in the Stockholm region in Sweden. At three months follow-up, 33 mothers participated and at 12 months 31. The advices varied from waiting one to 12 months. Eleven mothers were advised to trust their own feelings of readiness and six were advised to wait until they had dealt with their grief before becoming pregnant. At one year post-loss, most of the mothers felt that a suitable time for a subsequent pregnancy was as soon as the mother herself wanted. Mothers whose baby had died in utero were given radically different kinds of advice concerning a suitable time for a subsequent pregnancy. The best advice seems to be that the mother should wait until she, herself, feels ready.

Siblings' farewell to a stillborn sister or brother and parents' support to their older children: a questionnaire study from the parents' perspective.

This study aims to capture parental descriptions of how siblings take leave of and mourn a stillborn brother or sister and how their parents support them. Data were collected by questionnaires from 16 parents of siblings to a stillborn child one year after the stillbirth. Data were analysed numerically for the multiple-choice questions and content analysis was used for parental comments and descriptions. The results describe siblings' farewell to a stillborn brother or sister and how their parents in the midst of their own grief were involved in supporting siblings' wellbeing, and observed their mourning reactions. Although the findings need to be interpreted with caution, they may provide insight that enables staff to become more sensitive to the whole family experience in the practice of their profession. Further research into siblings' grief and parental support after stillbirth is crucial so that further light may be shed on their situation.

Differences within couples' experience of their hospital care and well-being three months after experiencing a stillbirth.

BACKGROUND: The present study aimed to investigate possible differences, within the couple, in their encounter with their stillborn child and the assistance of caregivers during the event and to evaluate the parents' psychological well-being three months after the stillbirth. METHODS: Twenty-two couples, who experienced a stillbirth, participated in the study. A study-specific questionnaire and a previously evaluated well-being questionnaire were used to assess the parents' psychological condition. Chi-square analysis, Wilcoxon's signed rank test, Student's paired t-test, and Spearman's rank correlation coefficient were used to detect differences within the couples. RESULTS: The parents had feelings of fear when they conceptualized the stillborn child, but with support from staff all but one couple held their child. The fathers had the same strong feelings of warmth, pride, tenderness, and grief as the mothers when they held the child. Most parents reported that the staff had treated them with understanding during the delivery. Three months after the event the mothers scored significantly higher on Negative Well-being, lower on Positive Well-being, and lower on General Well-being than the fathers. A majority of the mothers, but no fathers, were on sick leave three months after the event. CONCLUSIONS: Our study suggests that mothers and fathers need to be emotionally supported in the encounter with their stillborn child. The mothers' scoring of lower well-being may be due to a stronger antenatal attachment to the child. This should, however, be a subject of further studies.

The role of caregivers after a stillbirth: views and experiences of parents.

BACKGROUND: The clinical role of the caregiver to parents in the event of a stillbirth has yet to be defined. The aim of this paper was to focus on the caregivers' support as revealed by the parents' experiences. METHOD: One or both parents of 31 stillborn infants (> or =28 weeks) were interviewed twice, for a total of 57 interviews. The data analysis was conducted using a qualitative approach. RESULTS: Parents identified the caregivers' behavior and handling of the stillbirth as important. Findings showed that caregivers should support parents in moments of chaos and at other difficult times. The parents needed assistance in both facing and separating from the baby. The six "qualities" that summarized the findings were "support in chaos,""support in the meeting with and separation from the baby,""support in bereavement,""explanation of the stillbirth,""organization of the care," and "understanding the nature of grief." Findings indicate that the hospital is under an obligation to organize the care and make it possible for parents to see the same caregivers again, and to offer extra ultrasound investigations and checkups without unnecessary bureaucracy. CONCLUSION: We suggest that the "qualities" identified by the study findings should be implemented in clinical care, and could facilitate active guidance and counseling for bereaved parents who have experienced a stillbirth.