Materiały źródłowe

• #1 About Stillbirth | Stillbirth | CDC

  https://www.cdc.gov/stillbirth/about/index.html

  Stillbirth is more common than people may realize and remains a sad reality for many families. […] A stillbirth is when a fetus dies in the uterus after 20 weeks of pregnancy. Stillbirth is different from miscarriage. […] Stillbirth occurs in families of all races, ethnicities, and income levels, and to women of all ages. However, stillbirth occurs more commonly among certain groups of people including women who are 35 years of age or older, are of low socioeconomic status, smoke cigarettes during pregnancy, have certain medical conditions, such as high blood pressure, are pregnant with more than one baby (such as twins or triplets), and have had a stillbirth in the past. […] Health disparities in stillbirth are not rooted in biological or genetic differences between races and ethnicities. […] The loss of a baby due to stillbirth remains a sad reality for many families and takes a serious toll on families health and well-being.

• #1 Stillbirth Care: Nursing & Emotional Support | Vaia

  https://www.vaia.com/en-us/explanations/nursing/midwifery/stillbirth-care/

  The nursing profession plays a vital role in providing sensitive and humane care for parents experiencing a stillbirth. These parents are faced with an immense loss, and understanding their needs and providing appropriate comfort is of paramount importance. […] The primary goal of a nursing care plan for stillbirth is to help parents navigate through their grief while ensuring their physical well-being. It encompasses several critical steps. […] Midwifery’s key components in stillbirth care include ensuring the physical well-being of the mother, providing psychological support, and aiding in making critical decisions. […] Appropriate antenatal care following a stillbirth is crucial in ensuring both the physical and mental health of the mother. Midwives play a critical role in providing this care, which includes regular health checks, psychological support, and careful monitoring of the pregnancy.

• #1 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/perinatal-loss-nursing-care-plans/

  The loss of an infant through miscarriage, stillbirth, or neonatal death is perceived as a traumatic life experience. […] This care plan is directed at the emotional needs of the postpartum client who must cope with the death of a child. […] Providing compassionate and empathetic support to help parents navigate the intense grief and emotional distress associated with perinatal loss. […] Offering specialized counseling services to assist parents in processing their feelings, coping with grief, and promoting healing after perinatal loss. […] Ensuring thorough medical evaluation and appropriate care to address any physical complications or concerns following perinatal loss. […] Offering the option of autopsy and genetic testing to provide parents with answers about the cause of perinatal loss and assist in understanding any potential genetic or medical factors.

• #1 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/perinatal-loss-nursing-care-plans/

  One of the most difficult situations for nurses is caring for a client and her family when the pregnancy has spontaneously resulted in the baby’s death. […] Parents grieve in complex, individual, and powerful ways and require significant emotional support. […] The magnitude or weight of the loss is a factor in the extent and duration of the grief response. […] Emotional reactions may prevent the couple’s ability to process information and interpret the significance of events. […] These areas may be neglected because of the process of grieving and associated depression. […] It is important to understand the cultural context in which these parents are forced to grieve in isolation and the psychological consequences of grieving a loss not recognized by society. […] The client/couple may detach themselves and have a problem making decisions.

• #1 what do ob nurses do when a woman has a stillbirth and miscarriag – Ob/Gyn Nursing

  https://allnurses.com/ob-nurses-woman-stillbirth-miscarriag-t429062/

  Support the mother both physically and emotionally as much as possible. Chaplain services or a bereavement counselor may be called according to the patient’s wishes. Most facilities also put together bereavement packages- a photo of the baby, a lock of hair, foot prints and hand prints, etc. The family is allowed to keep the child with them until they are ready to say goodbye. At my previous hospital they could keep the child for as long as they needed- there is no time limit. […] We let the parents take home any blankets, clothing, or hats, that they used to clothe or wrap their baby in. We also offer to take photos of the baby and parents for them, if they so desire. […] Not just any OB nurse on our unit is assigned to a miscarriage or fetal demise – only nurses that have experience in dealing with such tragedies and feel that they can handle the emotional load.

• #1 How do health care providers manage stillbirth? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/stillbirth/topicinfo/managed

  Care after a stillbirth depends on when it occurs. […] Health care providers will then try to determine a cause for the stillbirth by examining the fetus, the placenta, and other tissues from the pregnancy and possibly by performing an autopsy. […] At the same time, providers will offer support to help the family cope with their loss. […] When or if the family wants to try for another pregnancy, providers can work with them to discuss any risk factors and possible ways to prevent another stillbirth. […] Removing the placenta once the fetus is removed or delivered is an important part of all pregnancies. […] Providers will try to figure out a cause for the stillbirth, if possible. […] Health care providers might examine a stillbirth by inspecting the exterior of the fetus, placenta, and other tissues.

• #1 Stillbirth Care – Miss Foundation

  https://www.missfoundation.org/providers/stillbirth-care/

  How to care for a baby who dies in utero, prior to birth. Have two care givers for delivery, preferably one is RTS Counselor. One care giver concentrates on baby, and one on the mother. Discuss with the delivering physician what to expect in the condition/appearance of the baby. Review the chart, ultrasound and prepare the parents! Be honest, but also explain that fears are almost always worse than reality. Reassure them that you are there to help them. […] Offer baby unclothed, wrapped in a blanket to parents for bonding. If lotion or powder is desired, place on the blanket, not the baby. […] Allow parents private time with baby and leave the camera with them. Get OUT of the room and take other family and friends with you. Explain to parents that you will be back in 15 minutes, sooner if needed. Also explain to other family and friends that parents need time alone with their baby. BE BACK IN 15 MINUTES! Control visitors by parents’ wishes, not the request of visitors.

• #1 Heather Florescue Is Changing How We Think About Stillbirth Care | URMC Newsroom

  https://www.urmc.rochester.edu/news/publications/rochester-medicine/heather-florescue-is-changing-how-we-think-about-stillbirth-care

  The day before Caroline and Ryan Caufield were due to have their first child, they learned their baby had no heartbeat. […] The next day, the Caufields were directed to Highland Hospitals bereavement suite, where OBGYN Heather Florescue walked them through every step of the delivery and beyond. […] Florescue, whose practice became part of URMC in December 2024, supported the Caufields throughout the birth of their daughter, Kiera, and also checked in the day after, on her day off. […] Florescue’s support during Kiera’s birth included doing whatever it took to give the Caufields what they needed. […] It’s vital work because so much about the aftermath of stillbirth is counterintuitive. […] Florescue encourages her patients to call whenever they have a question or even an inkling that something might not be right during pregnancy, no matter the time of day.

• #1 Stillbirth: prevention and supportive bereavement care

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10410959/

  Time spent seeing, holding, and saying goodbye to a stillborn baby after birth is cherished by many parents and is well documented in high income countries. […] Bereavement care guidelines advocate for parents to be offered and supported in this choice, as well as emphasising the importance and significance to parents of physical reminders of the baby such as photography, hand and footprints, and keepsakes. […] The long term psychological impact of time spent with the baby is challenging to assess because this intervention is not distinct but rather co-related to many other aspects of supportive care. […] Where this option is possible, parents report appreciation for the ability to revisit and revise decisions, such as hospitals storing photography and keepsakes for collection at a later date. It is all about choice.

• #1 Stillbirth: prevention and supportive bereavement care

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10410959/

  Around half of the two million stillbirths occurring worldwide each year are preventable. […] Alongside prevention, efforts to address stillbirth must include provision of high quality, supportive, and compassionate bereavement care to improve parents wellbeing. […] A growing body of evidence suggests beneficial effects for parents who received supportive care and were offered choices such as mode of birth and the option to see and hold their baby. […] Staff need support to be able to care for parents effectively, yet, studies consistently highlight the scarcity of specific bereavement care training for healthcare providers. […] Action must be taken with the evidence available now, in healthcare settings with high or low resources, to reduce stillbirths and improve training and care.

• #1 Heather Florescue Is Changing How We Think About Stillbirth Care | URMC Newsroom

  https://www.urmc.rochester.edu/news/publications/rochester-medicine/heather-florescue-is-changing-how-we-think-about-stillbirth-care

  By providing residents with formal education and space to reflect, Florescue and Marinescu hope to help keep future providers working within patient care. […] Through her extended care for patients, Florescue saw that loss families often find that the experience of making memories can help make a tragic day feel a little less so. […] Taking the time to read your baby a story or do the handprints and footprints is so important, Wimmer said. […] You can never make too many memories. […] Florescue started a library-cart program in hospitals to give parents the experience of reading to their child. […] It’s a form of recognition that they are parents. […] We got to spend 24 precious hours with her, trying to make a lifetime of memories, said Caroline. […] Everything they did in that room did help with the experience, said Caroline.

• #1 Supporting a Patient after Fetal Demise – Nursing CE Central

  https://nursingcecentral.com/lessons/supporting-a-patient-after-fetal-demise/

  Fetal demise or fetal death is defined as the delivery of a fetus showing no signs of life as indicated by the absence of breathing, heartbeats, pulsation of the umbilical cord, or definite movements of voluntary muscles. Fetal demise can happen at any time during pregnancy and is classified according to gestational age. A death that occurs before 20 weeks gestation is usually classified as a spontaneous abortion; those occurring after 20 weeks or a birth weight equal to or greater than 350 grams constitute a fetal demise or stillbirth. […] Healthcare providers play a pivotal role in the care of clients and families who suffer a pregnancy loss. This course will focus on supporting a client after fetal demise/stillbirth. […] After fetal demise, clients will experience physical effects that occur after giving birth. Clients will experience vaginal bleeding. In the first few days after birth, the blood is usually bright red and heavy; it will seem like a heavy menstrual period. Over time bleeding will become lighter.

• #1 An Evaluation of Italian Midwives’ Knowledge of Stillbirth Clinical Management, Bereavement Care and Prevention of Recurrences: A Post-Hoc Analysis of the BLOSSoM Study

  https://www.imrpress.com/journal/CEOG/49/10/10.31083/j.ceog4910226/htm

  Conclusions: Italian midwives are still not fully aware of international guidelines on stillbirth management. The definition of national guidelines endorsed by scientific societies, as well as specific training courses for midwives in Italian hospitals, could be the first steps to improve clinical and psychological management of perinatal loss. […] In the area of bereavement care, the present study underlines that Italian midwives generally inform women about milk production, although most of them have an inadequate knowledge about natural inhibition of lactation and the possibility of milk donation. The consequence is that women do not have an actual opportunity to choose the best pathway for them, since most often the only choice that is available to them is pharmacological inhibition of lactation.

• #1 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/perinatal-loss-nursing-care-plans/

  Recognize signs of developing or increasing somatic complaints, preoccupation with the death, loss of normal behavior patterns, overactivity with no apparent sense of loss, excessive hostility, or agitated depression. […] A place where family and friends can open up and share their feelings without restriction promotes comfort. […] Expression of grief is influenced by cultural/religious beliefs and expectations. […] Partnership in planning and decision-making acknowledges that the partner has also lost a child and may need time to express feelings of loss and receive support without having to be supportive of the client and others. […] The process of grieving is not usually a fluid progression through the stages to resolution; it is rather a fluctuation between stages and possibly involves skipping of stages.

• #1 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/perinatal-loss-nursing-care-plans/

  Facilitating connections with other parents who have experienced perinatal loss, allowing for shared experiences and mutual support. […] Educating parents about the normal grieving process, helping them understand that grief is individual and may evolve over time. […] Recognizing the impact of perinatal loss on partners and family members and offering support and resources to help them navigate their own grief and provide support to the grieving parent(s). […] Promoting education and training for healthcare providers to enhance their sensitivity, knowledge, and skills in supporting individuals and families dealing with perinatal loss. […] Grief is a deeply personal process that nevertheless follows a fairly predictable course. […] Perinatal losses have also been shown to have a substantial psychological impact on parents and families.

• #1 Stillbirth Care: Nursing & Emotional Support | Vaia

  https://www.vaia.com/en-us/explanations/nursing/midwifery/stillbirth-care/

  After a stillbirth, postnatal care extends beyond emotional support as the nursing team has the responsibility to guide mothers through the complex physical changes that occur, including the care for their breasts. […] Following childbirth, the body typically commences lactation – this is the production of milk in a woman’s breasts. After a stillbirth, milk production can be a distressing reminder of the loss. It also can lead to physical discomfort if not addressed correctly. […] Nurses can employ a variety of strategies to provide emotional support and assist the grieving process following a stillbirth. These usually encompass active listening, facilitating memories, and providing bereavement counselling. […] Nurses play a crucial role in supporting parents through the emotional and psychological trauma of a stillbirth, offering bereavement counselling and helping navigate difficult choices.

• #1 Supporting a Patient after Fetal Demise – Nursing CE Central

  https://nursingcecentral.com/lessons/supporting-a-patient-after-fetal-demise/

  An antibiotic is usually prescribed to prevent infection. […] Pain is common after giving birth; especially afterpains that feel like menstrual cramps or labor contractions. Afterpains help the uterus shrink back to its pre-pregnancy size. […] Breastmilk usually starts coming in within a few days after delivery, and the client may experience breast soreness, lactation, or engorgement. […] Sensitive, personalized support interventions that address the clients needs are vital to prevent short and long-term negative outcomes. Providing a client with understandable information, discussing options with them, empathy, caring, and tailoring care to their individual needs from the time of diagnosis to hospital discharge and follow-up are key.

• #1 The psychological support for women who underwent a stillbirth during their pregnancy: the quality of midwifery care | Rivista di Psichiatria

  https://www.rivistadipsichiatria.it/archivio/4064/articoli/40476/

  The midwife was more represented (72%). Most of them perceived certain situations mainly communicating the tragic news to the parents and encountering the stillborn baby after birth as extremely difficult and felt inadequately trained to deal with these events. […] The midwives role is essential for the empathic meaning because she can help in the burial process, facilitating the separation rituals and honoring the babys memory. […] Communication is the masterpiece of quality care because sensitive verbal and non-verbal communication with the bereaved mother provides memories that will help her initiate mourning and facilitate the grieving process: mothers/parents appreciated who call their baby by their name and treat their dead baby with affection and respect. […] Therefore, every midwife should receive support and training, including communication training, given the adverse consequences of using the insensitive language outlined in this essay.

• #1

  https://www.nursingcenter.com/cearticle?an=00149525-202004000-00012&Journal_ID=675992&Issue_ID=5501081

  The professional practices carried out during the death of the child affect the way in which the parents later elaborate their grief. This topic shows the professional practices that are beneficial to parents and those that make it difficult to overcome the loss. […] Action, behavior, and attitudes of healthcare professionals had direct consequences on parents. Those parents who received sensitive and understanding physical and emotional care emphasized that this was essential to face this terrible situation. However, parents felt more stressed and powerless when health professionals focused more on the clinical part of the death rather than on the emotional part. […] The lack of communication on the process to be carried out both in the case of stillbirth and neonatal death increased the pain and anguish of the parents.

• #1 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/perinatal-loss-nursing-care-plans/

  The death of a child requires unanticipated changes in parental roles. […] The client must convey that she is seen as a functional, competent person, even though she may not feel that way. […] Friends and family are often unsure how to provide support to bereaved parents. […] Support groups provide information and assistance from people who have experienced the same and give reassurance of normalcy of physical and emotional responses. […] The couple will need assistance in evaluating the risks associated with the subsequent pregnancy. […] Emotional responses to the death of a baby are unique to each parent and vary from feelings of self-blame and guilt, loneliness and emptiness, anger, fear, failure, and shame, to sadness and grief. […] It is extremely helpful if the nurse can recognize and validate the signs of grief work in the subsequent pregnancy.

• #1 Support & Care After a Stillbirth, University of Utah Health, Salt Lake City | University of Utah Health | University of Utah Health

  https://healthcare.utah.edu/womens-health/pregnancy-birth/stillbirth

  We also will help you with bereavement including referral to a bereavement specialist and support groups if desired. […] After you return home from the hospital, your OB/GYN or certified nurse-midwife will want to see you for a follow-up visit. […] Your provider may refer you to a maternal-fetal doctor at U of U Health if you are interested in receiving a consultation from one of our specialists. […] If you come to U of U Health for a consultation, you will meet with a maternal-fetal medicine specialist who has extensive experience in helping people who have had a stillbirth. […] During this consultation, the doctor will provide an in-depth review that may involve: talking to you about your pregnancy and the details of your child’s birth. […] We encourage those who have experienced a stillbirth to take advantage of the many resources available to help them heal.

• #1 Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-016-0806-2

  Parents would appreciate a healthcare system ready to provide emotional support following birth and discharge from hospital. […] Parents want improved training so that staff can provide tailored discussions and written information to help them make informed decisions about post-mortem and funeral arrangements.

• #1 ACOG SMFM Obstetric Care Consensus #10: Management of Stillbirth – SMFM Publications and Clinical Guidelines

  https://publications.smfm.org/publications/322-acog-smfm-obstetric-care-consensus-10-management-of/

  Stillbirth is one of the most common adverse pregnancy outcomes, occurring in 1 in 160 deliveries in the United States. […] The study of specific causes of stillbirth has been hampered by the lack of uniform protocols to evaluate and classify stillbirths and by decreasing autopsy rates. […] Evaluation of a stillbirth should include fetal autopsy; gross and histologic examination of the placenta, umbilical cord, and membranes; and genetic evaluation. […] Health care providers should weigh the risks and benefits of each strategy in a given clinical scenario and consider available institutional expertise. […] Patient support should include emotional support and clear communication of test results. […] Referral to a bereavement counselor, peer support group, or mental health professional may be advisable for management of grief and depression.

• #1 How do health care providers manage stillbirth? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  http://www.nichd.nih.gov/health/topics/stillbirth/topicinfo/managed

  With parents permission, providers may take tissue and fluid samples and send them to a lab for analyses. […] With parents permission, providers may do an autopsy. […] Experiencing a stillbirth can be devastating for a pregnant woman and her family. […] Families that have experienced a stillbirth should work with health care providers to identify and address any changeable risk factors before trying for another pregnancy.

• #1 When your baby is stillborn – UF Health

  https://ufhealth.org/care-sheets/when-your-baby-is-stillborn

  It is natural for parents to feel uneasy about these tests when they are dealing with the loss of a baby. But learning the cause of the stillbirth can help a woman have a healthy baby in the future. […] Stillbirth is a tragic event for a family. The grief of a pregnancy loss can raise the risk of postpartum depression. […] Most women who have had a stillbirth are very likely to have a healthy pregnancy in the future. […] Get special prenatal care. Women who have had a stillbirth will be watched carefully during pregnancy. They may need special tests to monitor their baby’s growth and well-being.

• #1 Care of Bereaved Parents After a Stillbirth | Article | GLOWM

  https://www.glowm.com/article/heading/vol-15–the-puerperium–care-of-bereaved-parents-after-a-stillbirth/id/415313

  Parents appreciated support and encouragement from staff to see and hold their baby. This helped to reinforce their identity as parents and the identity of the baby as part of their family. […] The discussion of perinatal post-mortem examination should be conducted in a private place and led by a trained staff member who has allocated adequate time for the conversation. Parents should be counseled on the likelihood of identifying a cause of death, but also of excluding known recurrent causes, and reassured that dignity is preserved during all investigations. […] Staff should ensure that mothers have been offered lactation suppression and that both parents are aware that they are eligible for parental leave. […] Many studies have highlighted that bereaved parents can benefit significantly from participation in support groups or online forums, so staff should ensure that parents are aware of available resources before they leave hospital.

• #1 Postnatal care after a stillbirth | Tommy’sCloseleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowCloseReconfirm cookies choice

  https://www.tommys.org/baby-loss-support/stillbirth-information-and-support/postnatal-care-after-stillbirth

  Many parents describe the walk out of hospital without their baby, after having a stillbirth, as one of the most difficult and devastating moments of their lives. […] You should be offered appointments for postnatal care and to discuss the results of any tests. […] With your consent, the hospital will get in touch with your GP, community midwife and health visitor to let them know what has happened. They will offer you care and support after you leave hospital. […] The team caring for you should also let you know about local support groups and other organisations which may be able to support you. […] You should be offered an appointment to talk to a doctor about the birth and to discuss the post-mortem and test results (if you chose to have these done). […] Following a stillbirth, many people find they feel overwhelmed by all the new information and difficult decisions they need to make.

• #1 Prior Stillbirth – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/obgyn/maternal-fetal-medicine/pregnancy-complications/prior-stillbirth

  Stillbirth is defined as a fetal death that occurs after 20 weeks of gestation. Approximately 6 in 1000 pregnancies in the United States end in a stillbirth. […] At Brigham and Womens Hospital (BWH), we provide highly specialized care for women with a prior stillbirth. Our Prior Stillbirth Clinic features a multidisciplinary team of experts, including maternal-fetal medicine (high-risk pregnancy) specialists, genetic specialists, pathologists, social workers and psychiatrists to optimize the care we provide to women and families who have experienced a prior stillbirth. […] For women and families who have experienced a prior stillbirth and are planning a future pregnancy, we offer preconception counseling to: Review the records from the prior stillbirth, Send any further work-up that is necessary, Discuss the potential risk of recurrence, Come up with an individualized care plan for the next pregnancy (including antenatal surveillance and delivery timing).

• #1 Stillbirth: prevention and supportive bereavement care

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10410959/

  However, some stillbirths are not currently preventable with evidence based interventions, and some might never be. […] All parents who experience a stillborn baby must receive high quality, supportive bereavement care. […] Bereavement care provision remains a lesser research focus, particularly as regards the impact of interventions on long term outcomes for families. […] High quality care for bereavement may mitigate some negative short and long term psychosocial consequences. […] Parents desire for a live child as soon as possible may outweigh any potential disadvantages, while health professionals may be unaware or unwilling to discuss this potential outcome. […] When discussing future stillbirth risk, healthcare providers must be sensitive to parents ideas, priorities, and needs to ensure that parents are adequately equipped for future pregnancy without compounding trauma and distress.

• #1 Prior Stillbirth – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/obgyn/maternal-fetal-medicine/pregnancy-complications/prior-stillbirth

  For women and families who have experienced a prior stillbirth, we monitor subsequent pregnancies more closely. […] The Prior Stillbirth Clinic will make individualized care plans, especially regarding antenatal surveillance and delivery timing, taking into account the reasons for the prior stillbirth and the growth and well-being of the current pregnancy. […] Women and families with a prior stillbirth face unique emotional and supportive needs during a subsequent pregnancy. […] In the Prior Stillbirth Clinic, our expert team has cared for hundreds of families who have experienced a prior stillbirth. […] At Brigham and Womens Hospital, experts in maternal-fetal medicine have formed an innovative collaboration with specialists in genetics, pathology, social work and psychiatry to provide comprehensive care to women and families with a prior history of a stillbirth. […] We strive to provide families with prior stillbirth excellent outcomes in future pregnancies, including not only healthy babies but the emotional and social support needed to make it through challenging pregnancies.

• #1 Stillbirth: prevention and supportive bereavement care | BMJ Medicine

  https://bmjmedicine.bmj.com/content/2/1/e000262

  The most common themes for parents included the memorable impact of staff behaviours; the importance of clear, timely information; the offer of spending time and making memories with their baby; and the need for health system readiness to provide support after birth and discharge. […] Staff identified a critical need for bereavement care training. […] Consensus has not been agreed internationally on what care should be provided to parents suffering a perinatal loss, and few guidelines are available at even on a national level. […] Despite these notable examples, national and international guidelines are sparse, particularly in low and middle income countries where most stillbirths occur and where parents report lower satisfaction with bereavement care. […] Perinatal bereavement care has unique considerations: parental support, communication, clinical decisions, and impact on staff.

• #1 The psychological support for women who underwent a stillbirth during their pregnancy: the quality of midwifery care | Rivista di Psichiatria

  https://www.rivistadipsichiatria.it/archivio/4064/articoli/40476/

  More is studied about womans care during pregnancy, labor and delivery, but there are no specific maternal support guidelines during this terrible event. […] Midwives may be best suited and in the best position to direct such training at the facility level. […] Midwifery care cannot be good if the unit does not provide bereavement support or training, nor the presence of a support person. […] Given the high attendance at these hospitals and the high birth rate, women who have given birth to a dead child are discharged the same day, which profoundly marks families who cannot receive adequate support. […] Midwives training experience […] Communication skills and grief training are required, together with the encouragement of continuing professional training. […] The midwives in this study were motivated to receive training on mourning and strategies to confront it and improve their communication skills.

• #1 Heather Florescue Is Changing How We Think About Stillbirth Care | URMC Newsroom

  https://www.urmc.rochester.edu/news/publications/rochester-medicine/heather-florescue-is-changing-how-we-think-about-stillbirth-care

  After further investigating patient care for loss families, Florescue quickly saw a gap in medical education. […] The education aspect of Star Legacy especially interested Florescue. […] Knowledge, not concern, was the missing piece. […] The tip book continues with short and simple directions to help guide providers through conversations with their patients. […] Parents want to know that someone else will remember their baby, which is why Florescue encourages loved ones to recognize birthdays, verbalize the child’s name, and even ask to see photos in order to give support. […] Together, Marinescu, Wimmer, and Florescue created the programming for the first OBGYN Residency Perinatal Loss Simulation, which was held in January 2024. […] It’s very lonely when you deliver a baby who has died, Florescue said.

• #1 Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-016-0806-2

  Parents and healthcare workers experiences of stillbirth can inform training, improve the provision of care and highlight areas for future research. […] The experiences of bereaved parents were recognised in a series of papers in the Lancet as key to bringing about change. […] The support received by the mother following the death of her child was the single most important factor in predicting the nature of the grief process that she would experience. […] Midwives find caring for bereaved families stressful and emotionally challenging, with many experiencing difficulty with this area of practice, feeling unprepared due to a lack of support and training. […] Despite the impact stillbirth has on both parents and staff, it remains an area in which most obstetricians and midwives receive little or no training.

• #1 L&D Nurse After Stillbirth – Ob/Gyn Nursing

  https://allnurses.com/l-amp-d-nurse-after-t649243/

  I have taken care of women who have very delicate preemies who are very critical and moms who have lost their babies. […] I think it allows me to be a better nurse because I am speaking from a place of understanding. […] Expect to be triggered during OB rotation…set up your support system before hand and have your coping activities planned out. Only time and experience will actually tell you whether or not you want to deal with this as your initial nursing job. Each person is different on what we can cope with. […] Ironically, my mothers who have lost their babies are my most precious patients.

• #1 what do ob nurses do when a woman has a stillbirth and miscarriag – Ob/Gyn Nursing

  https://allnurses.com/ob-nurses-woman-stillbirth-miscarriag-t429062/

  I encourage the parents and any other family to hold the baby. […] I believe things happen for a reason, so perhaps this was something the mother needed. […] I also cry on the way home and sometimes cry myself to sleep. Having said that, I feel that taking care of a family who lost their baby has given me opportunities to make the biggest difference in someone’s life, to be there and help someone through one of the hardest parts of their lives. […] However, in my view, when they come to have a baby (or discover their baby died at any gestation), the nursing care they receive during their tragedy will set the tone for their grieving, and the momentos offered by the nurse are the only tangible things they will have from their baby to take home, the compassion given to them at that time will forever be appreciated…perhaps to a more intense level than if they came, had their baby as expected and took it home.

• #1 CASaND Guideline | Stillbirth CRE eLearning

  https://learn.stillbirthcre.org.au/learn/casand/

  The Centre of Research Excellence in Stillbirth (Stillbirth CRE) and Perinatal Society of Australia and New Zealand (PSANZ) are pleased to publish the 2024 update of the Care Around Stillbirth and Neonatal Death Clinical Practice Guideline. This guideline represents our shared vision to improve care for parents and families/whnau who experience the tragedy of stillbirth or neonatal death. […] In this edition, a greater focus has been placed on culturally responsive and safe care practices and the role of organisations in enabling the provision of best practice care. […] We acknowledge the enduring loss experienced by parents and families/whnau when the anticipated joy of bringing a baby home turns to tragedy through pregnancy loss at any gestation. […] The 2024 edition of the Care Around Stillbirth and Neonatal Death Clinical Practice Guideline is endorsed by the following organisations.

• #1 Reducing the risk of stillbirth | The Royal Women’s Hospital

  https://www.thewomens.org.au/health-information/pregnancy-and-birth/a-healthy-pregnancy/reducing-the-risk-of-stillbirth

  Stillbirth is the term used for the death of a baby after 20 weeks of pregnancy and before or during birth. […] In Australia, one in every 135 pregnancies that reach 20 weeks will end with a stillborn child. For some women, including Aboriginal and Torres Strait Islander women and other disadvantaged groups, the risk of having a stillborn baby is higher. […] A number of issues increase your risk of stillbirth, these include: smoking, diabetes, high blood pressure, being overweight or obese, previously having had a stillbirth, being over 35 years of age, being over 41 weeks pregnant. […] There are no reliable screening tests to identify all babies that are at risk of stillbirth but there are some steps you can take to reduce the risk to you and your baby. Your pregnancy care team can support you with this.

• #1 Stillbirth: prevention and supportive bereavement care | BMJ Medicine

  https://bmjmedicine.bmj.com/content/2/1/e000262

  Around half of the two million stillbirths occurring worldwide each year are preventable. […] Alongside prevention, efforts to address stillbirth must include provision of high quality, supportive, and compassionate bereavement care to improve parents wellbeing. […] Staff need support to be able to care for parents effectively, yet, studies consistently highlight the scarcity of specific bereavement care training for healthcare providers. […] All parents who experience a stillborn baby must receive high quality, supportive bereavement care. […] Bereavement care provision remains a lesser research focus, particularly as regards the impact of interventions on long term outcomes for families. […] High quality care for bereavement may mitigate some negative short and long term psychosocial consequences.

• #1 Stillbirth Care: Nursing & Emotional Support | Vaia

  https://www.vaia.com/en-us/explanations/nursing/midwifery/stillbirth-care/

  Prenatal care and regular antenatal appointments are key in reducing the risk of stillbirths. Midwives play a key role in providing this type of care to expectant mothers. […] Proper prenatal care in preventing stillbirths essentially focuses on three main aspects: Monitoring the physical health of the expectant mother, keeping track of the baby’s development and wellbeing, and educating the mother about potential warning signs and encouraging prompt reporting of concerns. […] A nurse’s role in stillbirth care is diverse and multifaceted, involving both clinical care and emotional support. Specifically, nurses are often directly responsible for facilitating the bereavement process, fostering communication, providing education, and making certain logistical arrangements.

• #1 Perinatal Loss: How Nurses Can Provide Compassionate Care

  https://nursingcecentral.com/perinatal-loss-how-nurses-can-provide-compassionate-care/

  Perinatal loss is unimaginably difficult for patients, and as a provider, it can hard to know what to say or do in those moments. […] When you think of the labor and delivery specialty, it is typically known for their magical moments of new life and bonding, but there is little to prepare a nurse for the gut-wrenching, first-time experience of caring for a patient and their support system following a fetal loss. […] Regardless of the specialty, nurses have a longing to connect with people and in most cases, possess an invaluable skill of providing compassionate care to strangers who are in need. […] In instances of perinatal loss, in order to provide effective patient care, a nurse must allow connection and reaction to take precedence. […] When a patient has lost their child, a nurse must be able to read the room quickly. […] Perinatal loss is a saddening, but potential outcome of pregnancy, and nurses must be as prepared as they can be to handle difficult circumstances like this.

• #1 Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-016-0806-2

  Parents feel that there is a significant gap in healthcare professionals knowledge and comfort level dealing with perinatal loss and bereavement after stillbirth. […] Parents wish for increased awareness and acknowledgement of stillbirth. […] Parents want privacy not abandonment. […] Parents appreciated and feel reassured by meeting with familiar staff throughout their care. […] Parents with a baby who died in-utero may feel that their care is not appropriately prioritised by staff. […] Parents experience stillbirth not as a medical problem, but as the birth and death of a baby. […] Hospitals should consider developing specialist bereavement support services and employing specifically trained staff. […] A well-executed follow-up and debriefing appointment is beneficial to the parents grieving process.

• #1 Support & Care After a Stillbirth, University of Utah Health, Salt Lake City | University of Utah Health | University of Utah Health

  https://healthcare.utah.edu/womens-health/pregnancy-birth/stillbirth

  Losing a child to stillbirth is an emotionally devastating experience for parents. […] We provide compassionate care for women who deliver their baby at University of Utah Hospital, with an emphasis on helping them create memories with their child in their brief time together. […] Caring doctors, nurses, and other providers in our Womens Health Services will provide support and resources for those who have experienced a stillbirth. […] If you have your baby at University of Utah Hospital, our doctors and nurses will assist you with every aspect of the delivery. They will also help you create memories with your child during your time together. Many parents find that this helps them cope with their grief later. […] During your hospital stay, our staff will do everything possible to make you comfortable. A maternal-fetal medicine specialist from our Stillbirth Center may visit. They will provide emotional support and discuss our comprehensive consultations for women who have experienced a pregnancy loss.

• #1 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/perinatal-loss-nursing-care-plans/

  Members of the family may provide support for one another. […] Adjustment after bereavement has been empirically shown to occur through a sequence of stages in a longitudinal study of bereaved individuals. […] The second step in intervening after a perinatal loss involves talking with the parents to evaluate the actual loss experience and compare it to the standard of the desirable. […] Recognizing one’s feelings may trigger the realization of their causes and can be used to verify the acceptability of these feelings. […] The realization that feelings of grief, guilt, and anger are normal may help alleviate the parents’ sense of failure. […] In some instances, grief causes immobilization, resulting in dysfunctional parental patterns to the point that normal household routines are disturbed, and outside assistance is required.

• #1 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/perinatal-loss-nursing-care-plans/

  The parents may need more time for dealing with their concerns and may need more frequent visits to hear the fetal heartbeat or for reassurance. […] The nurse can direct the couples and their families to Internet sources that may protect them from poor-quality sites, with the goal of connecting them to evidence-based, up-to-date information specific to their loss.

• #1 Death of a baby | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/healthyliving/death-of-a-baby

  Suggestions include: Consider asking your health care provider to refer you to Red Nose Hospital to Home program. This program operates throughout Australia, providing outreach support within 3 months of loss to bereaved parents who have experienced the death of a baby or infant through stillbirth (including TFMR), neonatal death or the sudden unexpected death of an infant (SUDI). […] Many parents who experience a miscarriage, stillbirth (including TFMR) or neonatal death choose to try again for a child. However, pregnancy and new parenthood can be an anxious and bewildering time until the health and survival of the new baby feels more certain. […] Suggestions for any further pregnancies include: If your baby died from a genetic disorder, try to find out as much as you can about the disorder and seek genetic counselling.

• #2 What you need to know about stillbirths | UNICEF

  https://www.unicef.org/stories/what-you-need-to-know-about-stillbirths

  One stillbirth happens every 16 seconds. That’s about 2 million babies stillborn every year. What makes these deaths even more tragic is that the majority could have been prevented through quality care during pregnancy and at birth. […] The majority of stillbirths can be prevented through quality care during pregnancy and at birth. […] From what we do know about the causes of stillbirth, it is clear that providing quality care, support and resources that encourage healthy lifestyles and pregnancies can greatly reduce a woman’s risk of stillbirth. […] Improved health systems and high-quality antenatal and delivery care are critical to ending preventable stillbirths. This means access to functional health facilities with adequate medicine and equipment, electricity, running water, soap and blankets, and the availability of round-the-clock referral systems every day of the week. Adequate numbers of competent health care workers are essential, including midwives in the public and private sectors trained to national and international standards.

• #2 Stillbirth: How Common, Causes, Symptoms & Support

  https://my.clevelandclinic.org/health/diseases/9685-stillbirth

  A stillbirth happens when the fetus dies after week 20 of pregnancy. Stillbirths can have multiple causes, including problems with the placenta or umbilical cord, genetic conditions that affect the fetus or pregnancy complications. A stillbirth is a jarring pregnancy loss, similar to a miscarriage. Stillbirths involve fetal death after week 20, while miscarriage involves the fetus passing away before week 20. Like a miscarriage, a stillbirth is a traumatizing event that may require lots of time and a strong support network to grieve. Your healthcare provider will recommend the safest option available to deliver the fetus. The experience will feel similar to delivering a live baby. Your pregnancy care team will coach you and give you medicines to help with the pain. Take as much time as you need to grieve after a stillbirth. Mourn in ways that feel most healing for you. This may mean having a funeral to grieve alongside friends and family members who want to support you during this time.

• #2 Stillbirth: prevention and supportive bereavement care

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10410959/

  However, some stillbirths are not currently preventable with evidence based interventions, and some might never be. […] All parents who experience a stillborn baby must receive high quality, supportive bereavement care. […] Bereavement care provision remains a lesser research focus, particularly as regards the impact of interventions on long term outcomes for families. […] High quality care for bereavement may mitigate some negative short and long term psychosocial consequences. […] Parents desire for a live child as soon as possible may outweigh any potential disadvantages, while health professionals may be unaware or unwilling to discuss this potential outcome. […] When discussing future stillbirth risk, healthcare providers must be sensitive to parents ideas, priorities, and needs to ensure that parents are adequately equipped for future pregnancy without compounding trauma and distress.

• #2 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/perinatal-loss-nursing-care-plans/

  The loss of an infant through miscarriage, stillbirth, or neonatal death is perceived as a traumatic life experience. […] This care plan is directed at the emotional needs of the postpartum client who must cope with the death of a child. […] Providing compassionate and empathetic support to help parents navigate the intense grief and emotional distress associated with perinatal loss. […] Offering specialized counseling services to assist parents in processing their feelings, coping with grief, and promoting healing after perinatal loss. […] Ensuring thorough medical evaluation and appropriate care to address any physical complications or concerns following perinatal loss. […] Offering the option of autopsy and genetic testing to provide parents with answers about the cause of perinatal loss and assist in understanding any potential genetic or medical factors.

• #2 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/perinatal-loss-nursing-care-plans/

  Facilitating connections with other parents who have experienced perinatal loss, allowing for shared experiences and mutual support. […] Educating parents about the normal grieving process, helping them understand that grief is individual and may evolve over time. […] Recognizing the impact of perinatal loss on partners and family members and offering support and resources to help them navigate their own grief and provide support to the grieving parent(s). […] Promoting education and training for healthcare providers to enhance their sensitivity, knowledge, and skills in supporting individuals and families dealing with perinatal loss. […] Grief is a deeply personal process that nevertheless follows a fairly predictable course. […] Perinatal losses have also been shown to have a substantial psychological impact on parents and families.

• #2

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abk9885

  Stillbirth is the loss of a baby after 20 weeks of pregnancy. When a baby dies while still in the uterus, this may also be called fetal loss. […] The loss of a baby can be hard. And you may wonder why it happened. Fetal loss can happen even during a pregnancy that has been going well. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if you are having problems. […] After a stillbirth, there are things you can do for your physical and emotional health and comfort. […] Talk to your doctor or midwife about how you are coping. Your doctor or midwife will want to watch you for signs of depression. You may want to have counselling for support and to help you express your feelings. […] If you can, try to talk to others who have gone through this loss. You can make connections online or in person. Ask your hospital to recommend local programs or organizations that can help support you and your family.

• #2 Heather Florescue Is Changing How We Think About Stillbirth Care | URMC Newsroom

  https://www.urmc.rochester.edu/news/publications/rochester-medicine/heather-florescue-is-changing-how-we-think-about-stillbirth-care

  The day before Caroline and Ryan Caufield were due to have their first child, they learned their baby had no heartbeat. […] The next day, the Caufields were directed to Highland Hospitals bereavement suite, where OBGYN Heather Florescue walked them through every step of the delivery and beyond. […] Florescue, whose practice became part of URMC in December 2024, supported the Caufields throughout the birth of their daughter, Kiera, and also checked in the day after, on her day off. […] Florescue’s support during Kiera’s birth included doing whatever it took to give the Caufields what they needed. […] It’s vital work because so much about the aftermath of stillbirth is counterintuitive. […] Florescue encourages her patients to call whenever they have a question or even an inkling that something might not be right during pregnancy, no matter the time of day.

• #2 An Evaluation of Italian Midwives’ Knowledge of Stillbirth Clinical Management, Bereavement Care and Prevention of Recurrences: A Post-Hoc Analysis of the BLOSSoM Study

  https://www.imrpress.com/journal/CEOG/49/10/10.31083/j.ceog4910226/htm

  Midwives showed a lack of information about the possibility that women could suffer from so called “empty arms syndrome” (a condition still to be properly defined, in which bereaved mothers’ arms are aching for not holding a baby) and feel phantom baby kicks, a phenomenon that sometimes happens also in women who had a physiological pregnancy and birth, even after several years. […] In the area of clinical management, the large use of sedatives and analgesia stands out. Although childbirth analgesia should be always offered to women in cases of stillbirth, it is well known that sedation may instead interfere with the grieving process and make re-living the experience in the days and months later more difficult. […] Regarding aftercare, the majority of Italian midwives did not plan more than one follow-up visit and did not activate any home care service. International guidelines suggest a different pathway of care: more than one follow-up should be scheduled not only with the purpose of physical evaluation, but also in order to provide adequate psychological support.

• #2 Heather Florescue Is Changing How We Think About Stillbirth Care | URMC Newsroom

  https://www.urmc.rochester.edu/news/publications/rochester-medicine/heather-florescue-is-changing-how-we-think-about-stillbirth-care

  After further investigating patient care for loss families, Florescue quickly saw a gap in medical education. […] The education aspect of Star Legacy especially interested Florescue. […] Knowledge, not concern, was the missing piece. […] The tip book continues with short and simple directions to help guide providers through conversations with their patients. […] Parents want to know that someone else will remember their baby, which is why Florescue encourages loved ones to recognize birthdays, verbalize the child’s name, and even ask to see photos in order to give support. […] Together, Marinescu, Wimmer, and Florescue created the programming for the first OBGYN Residency Perinatal Loss Simulation, which was held in January 2024. […] It’s very lonely when you deliver a baby who has died, Florescue said.

• #2 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/perinatal-loss-nursing-care-plans/

  Recognize signs of developing or increasing somatic complaints, preoccupation with the death, loss of normal behavior patterns, overactivity with no apparent sense of loss, excessive hostility, or agitated depression. […] A place where family and friends can open up and share their feelings without restriction promotes comfort. […] Expression of grief is influenced by cultural/religious beliefs and expectations. […] Partnership in planning and decision-making acknowledges that the partner has also lost a child and may need time to express feelings of loss and receive support without having to be supportive of the client and others. […] The process of grieving is not usually a fluid progression through the stages to resolution; it is rather a fluctuation between stages and possibly involves skipping of stages.

• #2 Heather Florescue Is Changing How We Think About Stillbirth Care | URMC Newsroom

  https://www.urmc.rochester.edu/news/publications/rochester-medicine/heather-florescue-is-changing-how-we-think-about-stillbirth-care

  By providing residents with formal education and space to reflect, Florescue and Marinescu hope to help keep future providers working within patient care. […] Through her extended care for patients, Florescue saw that loss families often find that the experience of making memories can help make a tragic day feel a little less so. […] Taking the time to read your baby a story or do the handprints and footprints is so important, Wimmer said. […] You can never make too many memories. […] Florescue started a library-cart program in hospitals to give parents the experience of reading to their child. […] It’s a form of recognition that they are parents. […] We got to spend 24 precious hours with her, trying to make a lifetime of memories, said Caroline. […] Everything they did in that room did help with the experience, said Caroline.

• #2 Stillbirth: prevention and supportive bereavement care

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10410959/

  Time spent seeing, holding, and saying goodbye to a stillborn baby after birth is cherished by many parents and is well documented in high income countries. […] Bereavement care guidelines advocate for parents to be offered and supported in this choice, as well as emphasising the importance and significance to parents of physical reminders of the baby such as photography, hand and footprints, and keepsakes. […] The long term psychological impact of time spent with the baby is challenging to assess because this intervention is not distinct but rather co-related to many other aspects of supportive care. […] Where this option is possible, parents report appreciation for the ability to revisit and revise decisions, such as hospitals storing photography and keepsakes for collection at a later date. It is all about choice.

• #2 Supporting a Patient after Fetal Demise – Nursing CE Central

  https://nursingcecentral.com/lessons/supporting-a-patient-after-fetal-demise/

  An antibiotic is usually prescribed to prevent infection. […] Pain is common after giving birth; especially afterpains that feel like menstrual cramps or labor contractions. Afterpains help the uterus shrink back to its pre-pregnancy size. […] Breastmilk usually starts coming in within a few days after delivery, and the client may experience breast soreness, lactation, or engorgement. […] Sensitive, personalized support interventions that address the clients needs are vital to prevent short and long-term negative outcomes. Providing a client with understandable information, discussing options with them, empathy, caring, and tailoring care to their individual needs from the time of diagnosis to hospital discharge and follow-up are key.

• #2 Stillbirth postnatal care – Stillbirth Foundation Australia

  https://stillbirthfoundation.org.au/help-and-support/postnatal-care/

  Postnatal care is an important part of your journey and recovery. […] Not all women experience lactation following a stillbirth and some might experience fullness of the breasts. […] You will experience emotion and heartache as part of the grieving process however women can also experience the baby blues after giving birth. […] Our bereaved mothers, families and healthcare professionals stress the importance of self-care for both parents. […] The above may not suit all personalities and beliefs but are a sample of self-care and healing modalities available to help bereaved mothers. […] Stillbirth is never planned. Understanding what happens now can make it less overwhelming. […] Every persons experience of grief and loss is unique. […] In hospital or on your return home, you may start to focus your attention on organising a funeral or ceremony to honour your child. […] In Australia, it is a requirement to register your babys birth if the loss was after 20 weeks of pregnancy or weighing more than 400 grams at birth.

• #2 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/perinatal-loss-nursing-care-plans/

  If the process of grieving is not completed, grief may become dysfunctional, resulting in behaviors that are disturbing to personal safety and the future of the family and marriage/relationship. […] The nurse can counsel the couple on the importance of sharing feelings, experiences, and needs in a non-threatening manner. […] The family may want to meet with a minister or spiritual advisor to provide baptism, last rites, cultural rituals, and/or counseling. […] Families may want or need an explanation of the cause of death, which may not be possible. […] The family may need support in planning the cost of a funeral and other necessities. […] This provides the client or the couple with the opportunity to discuss and ask questions. […] Severe grief response may be noted in older women and those with longer-term pregnancies.

• #2 Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences | BMC Pregnancy and Childbirth | Full Text

  https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-016-0806-2

  Parents feel that there is a significant gap in healthcare professionals knowledge and comfort level dealing with perinatal loss and bereavement after stillbirth. […] Parents wish for increased awareness and acknowledgement of stillbirth. […] Parents want privacy not abandonment. […] Parents appreciated and feel reassured by meeting with familiar staff throughout their care. […] Parents with a baby who died in-utero may feel that their care is not appropriately prioritised by staff. […] Parents experience stillbirth not as a medical problem, but as the birth and death of a baby. […] Hospitals should consider developing specialist bereavement support services and employing specifically trained staff. […] A well-executed follow-up and debriefing appointment is beneficial to the parents grieving process.

• #2

  https://www.nursingcenter.com/cearticle?an=00149525-202004000-00012&Journal_ID=675992&Issue_ID=5501081

  The parents showed the absence of care after death and hospital discharge feeling abandoned, marginalized, unprotected, and did not know what to expect during the postnatal period. […] Most parents did not receive information about their rights, possible reactions, needs, and probable coping resources such as books, online resources, memorial websites, or support groups. […] The silence surrounding stillbirth and neonatal death had been identified as one of the most difficult parts of mourning. Parents felt that they could not express their emotions or remember their infant in public because the rest of society did not recognize their loss or understand their needs. […] Relatives and close friends were key and essential elements to overcome the mourning process, but both mothers and fathers emphasized the support provided by their partner as a primary element to overcome the loss. […] Perinatal loss support groups provide parents with a unique opportunity to talk about the topic in an empathic environment where their loss is accepted without any kind of prejudice.

• #2 Postnatal care after a stillbirth | Tommy’sCloseleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowCloseReconfirm cookies choice

  https://www.tommys.org/baby-loss-support/stillbirth-information-and-support/postnatal-care-after-stillbirth

  Many people find it helpful to talk with other parents who have had a stillborn baby. Your bereavement midwife or maternity team should be able to tell you about local and/or national baby loss support groups and counselling services. […] If you’re worried that you or your partner are struggling to cope after losing a baby, it may help to talk to your GP. They should be able to help you get further support.

• #2

• #2 When your baby is stillborn – UF Health

  https://ufhealth.org/care-sheets/when-your-baby-is-stillborn

  A stillbirth is when a baby dies in the womb during the last 20 weeks of pregnancy. […] About 1 in 160 pregnancies end in stillbirth. Stillbirth is less common than in the past because of better pregnancy care. Up to one half of the time, the reason for the stillbirth is never known. […] The health care provider will use an ultrasound to confirm that the baby’s heart has stopped beating. If the woman’s health is at risk, she will need to deliver the baby right away. Otherwise, she can choose to have medicine to start labor or wait for labor to begin on its own. […] After the delivery, the provider will look at the placenta, fetus, and umbilical cord for signs of problems. The parents will be asked for permission to do more detailed tests. These may include internal exams (autopsy), x-rays, and genetic tests.

• #2 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/perinatal-loss-nursing-care-plans/

  The parents may need more time for dealing with their concerns and may need more frequent visits to hear the fetal heartbeat or for reassurance. […] The nurse can direct the couples and their families to Internet sources that may protect them from poor-quality sites, with the goal of connecting them to evidence-based, up-to-date information specific to their loss.

• #2 Stillbirth: prevention and supportive bereavement care | BMJ Medicine

  https://bmjmedicine.bmj.com/content/2/1/e000262

  Around half of the two million stillbirths occurring worldwide each year are preventable. […] Alongside prevention, efforts to address stillbirth must include provision of high quality, supportive, and compassionate bereavement care to improve parents wellbeing. […] Staff need support to be able to care for parents effectively, yet, studies consistently highlight the scarcity of specific bereavement care training for healthcare providers. […] All parents who experience a stillborn baby must receive high quality, supportive bereavement care. […] Bereavement care provision remains a lesser research focus, particularly as regards the impact of interventions on long term outcomes for families. […] High quality care for bereavement may mitigate some negative short and long term psychosocial consequences.

• #2 Stillbirth: prevention and supportive bereavement care | BMJ Medicine

  https://bmjmedicine.bmj.com/content/2/1/e000262

  Across studies providers frequently reported a paucity of training as a barrier to provision of high quality bereavement care. […] The SUPPORT course is UK based, providing training for healthcare professionals in caring for parents suffering any perinatal bereavement from early pregnancy to neonatal death. […] Time spent seeing, holding, and saying goodbye to a stillborn baby after birth is cherished by many parents and is well documented in high income countries. […] Bereavement care guidelines advocate for parents to be offered and supported in this choice, as well as emphasising the importance and significance to parents of physical reminders of the baby such as photography, hand and footprints, and keepsakes. […] Identification of stillbirth causation is important. […] All parents should be offered thorough and appropriate investigations after stillbirth. […] Parents must be counselled by appropriately knowledgeable and trained health professionals to make the right decision for them.

• #2 Care of Bereaved Parents After a Stillbirth | Article | GLOWM

  https://www.glowm.com/article/heading/vol-15–the-puerperium–care-of-bereaved-parents-after-a-stillbirth/id/415313

  All the literature on care for bereaved parents after a stillbirth emphasizes that mothers and fathers may respond differently to the loss of their baby. […] The authors cited in this chapter universally recognise that any improvements in care for bereaved parents will need to acknowledge deeply embedded cultural beliefs, practices and misconceptions surrounding stillbirth, as well as local resource constraints. […] Staff should receive standardized training in perinatal bereavement care, including the importance of non-technical skills, and should be able to access dedicated professional support.

• #2

  https://www.who.int/health-topics/stillbirth

  A baby who dies after 28 weeks of pregnancy, but before or during birth, is classified as a stillbirth. […] Over 40% of all stillbirths occur during labour a loss that could be avoided with improved quality and respectful care during childbirth including routine monitoring and timely access to emergency obstetric care when required. […] With quality health care throughout pregnancy and childbirth, most stillbirths are preventable. […] Stillbirths can be prevented through family planning to avoid unwanted pregnancies, good health and nutrition prior to and during pregnancy, quality and respectful antenatal and childbirth care including adequate skilled health personnel including midwives. […] Prevention and responsive care need to be integrated across the continuum of maternal health care, and beyond. This includes respectful and supportive care in the event of a death.

• #2 What you can do to reduce the risk of stillbirth – NHS

  https://www.nhs.uk/pregnancy/keeping-well/reducing-the-risk-of-stillbirth/

  Stillbirth is when a baby dies before she or he is born, after 24 weeks of pregnancy. In England, around 1 in 250 births is a stillbirth. […] Not all the causes of stillbirth are currently known and it’s not possible to prevent every stillbirth. […] But we do know that certain factors increase the risk, and there are simple things you can do to reduce these risks. […] It’s important not to miss any of your antenatal appointments or scans. […] Some of the tests and measurements that can identify potential problems have to be done at specific times. […] Research suggests that going to sleep on your back after 28 weeks of pregnancy doubles the risk of stillbirth. […] It’s thought this may be to do with the flow of blood and oxygen to the baby. […] Using illegal drugs during pregnancy could harm your baby. […] If left untreated, ICP can lead to premature labour and increase the risk of stillbirth.

• #2

  https://www.nhs.uk/conditions/stillbirth/

  A stillbirth is when a baby is born dead after 24 completed weeks of pregnancy. It happens in around 1 in every 250 births in England. […] After a stillbirth, decisions about what to do are very personal. There’s no right or wrong way to respond. […] A specialist midwife will talk with you about what you want to do for example, holding the baby or taking photographs. They can also discuss the tests you may be offered to find out why your baby died and give you information about registering the birth. […] Not all stillbirths can be prevented, but there are some things you can do to reduce your risk, such as: not smoking, avoiding drugs and alcohol during pregnancy these can seriously affect your baby’s development, and increase the risk of miscarriage and stillbirth, not going to sleep on your back after 28 weeks don’t worry if you wake up on your back, just turn onto your side before you go back to sleep, attending all your antenatal appointments so that midwives can monitor the growth and wellbeing of your baby, taking folic acid before and up to 12 weeks of pregnancy, making sure all your vaccinations are up to date speak to your midwife or GP for advice, limiting the amount of caffeine you consume during pregnancy.

• #2 Support & Care After a Stillbirth, University of Utah Health, Salt Lake City | University of Utah Health | University of Utah Health

  https://healthcare.utah.edu/womens-health/pregnancy-birth/stillbirth

  We also will help you with bereavement including referral to a bereavement specialist and support groups if desired. […] After you return home from the hospital, your OB/GYN or certified nurse-midwife will want to see you for a follow-up visit. […] Your provider may refer you to a maternal-fetal doctor at U of U Health if you are interested in receiving a consultation from one of our specialists. […] If you come to U of U Health for a consultation, you will meet with a maternal-fetal medicine specialist who has extensive experience in helping people who have had a stillbirth. […] During this consultation, the doctor will provide an in-depth review that may involve: talking to you about your pregnancy and the details of your child’s birth. […] We encourage those who have experienced a stillbirth to take advantage of the many resources available to help them heal.

• #2 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/perinatal-loss-nursing-care-plans/

  The death of a child requires unanticipated changes in parental roles. […] The client must convey that she is seen as a functional, competent person, even though she may not feel that way. […] Friends and family are often unsure how to provide support to bereaved parents. […] Support groups provide information and assistance from people who have experienced the same and give reassurance of normalcy of physical and emotional responses. […] The couple will need assistance in evaluating the risks associated with the subsequent pregnancy. […] Emotional responses to the death of a baby are unique to each parent and vary from feelings of self-blame and guilt, loneliness and emptiness, anger, fear, failure, and shame, to sadness and grief. […] It is extremely helpful if the nurse can recognize and validate the signs of grief work in the subsequent pregnancy.

• #3

  https://www.nhs.uk/conditions/stillbirth/

  A stillbirth is when a baby is born dead after 24 completed weeks of pregnancy. It happens in around 1 in every 250 births in England. […] After a stillbirth, decisions about what to do are very personal. There’s no right or wrong way to respond. […] A specialist midwife will talk with you about what you want to do for example, holding the baby or taking photographs. They can also discuss the tests you may be offered to find out why your baby died and give you information about registering the birth. […] Not all stillbirths can be prevented, but there are some things you can do to reduce your risk, such as: not smoking, avoiding drugs and alcohol during pregnancy these can seriously affect your baby’s development, and increase the risk of miscarriage and stillbirth, not going to sleep on your back after 28 weeks don’t worry if you wake up on your back, just turn onto your side before you go back to sleep, attending all your antenatal appointments so that midwives can monitor the growth and wellbeing of your baby, taking folic acid before and up to 12 weeks of pregnancy, making sure all your vaccinations are up to date speak to your midwife or GP for advice, limiting the amount of caffeine you consume during pregnancy.

• #3 Postnatal care after a stillbirth | Tommy’sCloseleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowleft-arrowCloseReconfirm cookies choice

  https://www.tommys.org/baby-loss-support/stillbirth-information-and-support/postnatal-care-after-stillbirth

  Many parents describe the walk out of hospital without their baby, after having a stillbirth, as one of the most difficult and devastating moments of their lives. […] You should be offered appointments for postnatal care and to discuss the results of any tests. […] With your consent, the hospital will get in touch with your GP, community midwife and health visitor to let them know what has happened. They will offer you care and support after you leave hospital. […] The team caring for you should also let you know about local support groups and other organisations which may be able to support you. […] You should be offered an appointment to talk to a doctor about the birth and to discuss the post-mortem and test results (if you chose to have these done). […] Following a stillbirth, many people find they feel overwhelmed by all the new information and difficult decisions they need to make.

• #3 3 Perinatal Loss (Miscarriage, Stillbirth, Neonatal Death) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/perinatal-loss-nursing-care-plans/

  Members of the family may provide support for one another. […] Adjustment after bereavement has been empirically shown to occur through a sequence of stages in a longitudinal study of bereaved individuals. […] The second step in intervening after a perinatal loss involves talking with the parents to evaluate the actual loss experience and compare it to the standard of the desirable. […] Recognizing one’s feelings may trigger the realization of their causes and can be used to verify the acceptability of these feelings. […] The realization that feelings of grief, guilt, and anger are normal may help alleviate the parents’ sense of failure. […] In some instances, grief causes immobilization, resulting in dysfunctional parental patterns to the point that normal household routines are disturbed, and outside assistance is required.

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