Table 2

Comparison of Parents’ and Physicians’ Beliefs and Feelings
Practice Domain Themes: Mothers/Parents Themes: Physicians
1 Knowledge/awareness Believe that stillbirth happens more in low-resource countries. Believe that stillbirth happens more in low-resource countries.
Never expected this to happen and were shocked and unprepared. NICUs are better prepared to handle deaths.
Wanted to know the reason but no one could tell them the reason. Except for obvious causes (cord/abruption), doctors often don’t know why stillbirths happen.
2 Hospital – environment Being surrounded by reminders and sounds of healthy deliveries causes feelings of humiliation and anger on top of grief. Believe that efforts are made to offer privacy and sensitive support.
Overwhelmed, adding insult to injury, by having to explain (sometimes repeatedly) what happened to unprepared staff. Accustomed to handing off patients (mother and infant) to a pediatrician or neonatologist.
Appreciated the presence of physicians, social workers, and nurses who provided support to parents in grief and bereavement. Most feeling unprepared to shift from role of physician to counselor.
3 Hospital – care & communication Wanting physicians to engage them in their sadness and grief. Wanting to suppress/hide sadness and grief to focus on finding out ‘why’ for the patient.
Feeling shut out, not knowing. Wanting to figure out the cause through tests or autopsy.
Wanting answers but not strongly blaming self. Wanting to reassure mothers in particular not to blame themselves.
Holding someone responsible: Some blame the hospital or physician for not preventing the stillbirth. Some worried about being blamed.
4 Rituals around death Holding, bathing, dressing, photos, hand and footprints are important and preserve memories. However, should be offered, not forced. Some offered death kits similar to those used in NICUs; others felt unfamiliar with what a parent might want and would defer to nursing staff.
5 Post-stillbirth care Described grief as ambiguous—wanting to remember deeply sad memories. Focused on reassurances about the future. Referrals to social work but few referrals to mental health professionals for follow-up care.
Hunger for information on causes, prevention, and support resources. Few were offered this in hospital. Typically make referrals to nursing or social work to offer information.
Parent support groups and online groups helpful—someone who has gone through stillbirth and come out on the other side. Not aware of these resources.
6 Post-stillbirth communication This baby mattered to us and another baby will not replace her or make our feelings go away. It is important to reassure mothers they did nothing wrong and can have another baby.
7 How stillbirth is perceived A stillbirth is the death of a child. A stillbirth is not as severe a loss as the death of a neonate.
8 Bereavement, remembrance, & recovery We want to openly remember our baby as part of our family. It is important to try to help them realize they have done nothing wrong and can go on to have another child.

Kelley and Trinidad

Kelley and Trinidad BMC Pregnancy and Childbirth 2012 12:137   doi:10.1186/1471-2393-12-137

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