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

Siassakos, D; Jackson, S; Gleeson, K; Chebsey, C; Ellis, A; Storey, C; INSIGHT Study Group, .; (2018) All bereaved parents are entitled to good care after stillbirth: a mixed-methods multicentre study (INSIGHT). BJOG: An International Journal of Obstetrics & Gynaecology , 125 (2) pp. 160-170. 10.1111/1471-0528.14765. Green open access

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Abstract

Objective: To understand challenges in care after stillbirth and provide tailored solutions. // Design: Multi‐centre case study. // Setting: Three maternity hospitals. // Population: Parents with a stillborn baby, maternity staff. // Methods: Thematic analysis of parent interviews and staff focus groups and service provision investigation. // Outcomes: 1 Themes; 2 Triangulation matrix; 3 Recommendations. // Results: Twenty‐one women, 14 partners, and 22 staff participated. // Service Provision: Care for parents after stillbirth varies excessively; there are misconceptions; post‐mortem does not delay follow‐up. // Presentation: Women ‘do not feel right’ before stillbirth; their management is haphazard and should be standardised. // Diagnosis: Stillbirth is an emergency for parents but not always for staff; communication can seem cold; well‐designed bereavement space is critical. // Birth: Staff shift priorities to mother and future, but for parents their baby is still a baby; parents are not comfortable with staff recommending vaginal birth as the norm; there are several reasons why parents ask for a caesarean; better care involves clear communication, normal behaviour, and discussion of coping strategies. // Post‐mortem: Parents are influenced by discussions with staff. Staff should ‘sow seeds’, clarify its respectful nature, delineate its purpose, and explain the timescale. // Follow‐up: It is not standardised; parents wish to see their multi‐professional team. // Conclusions: There is unacceptable variation in care after stillbirth, and insensitive interactions between staff and bereaved parents. Understanding parents' needs, including why they ask for caesarean birth, will facilitate joint decision‐making. Every bereaved parent is entitled to good, respectful care.

Type: Article
Title: All bereaved parents are entitled to good care after stillbirth: a mixed-methods multicentre study (INSIGHT)
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/1471-0528.14765
Publisher version: https://doi.org/10.1111/1471-0528.14765
Language: English
Additional information: © 2017 The Authors. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
Keywords: Bereavement, communication, mode of birth, postmortem, stillbirth, training
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Maternal and Fetal Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10055980
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