The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.
Assessment of guidelines for good practice in psychosocial care of mothers after stillbirth: a cohort study
Abstract
Background Most maternity units have good practice protocols, advising that after stillbirth parents should be encouraged to see and hold their dead infant. Our aim was to assess whether adherence to these protocols is associated with measurably beneficial effects on the psychological health of mother and next-born child. This study forms part of a wider case-control study of the psychological effects of stillbirth.Methods We identified 65 women in the pregnancy after stillbirth, and enrolled matched controls for 60 of them. Outcome measures included depression, anxiety, and post-traumatic-stress disorder (PTSD) in pregnancy and 1 year after the next birth, and disorganised attachment behaviour in the next-born infant. Comparison variables included seeing and holding the stillborn infant, having a funeral, and keeping mementoes.Findings Behaviours that promote contact with the stillborn infant were associated with worse outcome. Women who had held their stillborn infant were more depressed than those who only saw the infant, while those who did not see the infant were least likely to be depressed (13 of 33, 39%, vs three of 14, 21%, vs one of 17, 6%; p=0.03). Women who had seen their stillborn infant had greater anxiety (p=0.02) and higher symptoms of PTSD than those who had not (p=0.02), and their next-born infants were more likely to show disorganised attachment behaviour (18 of 43, 42%, vs one of 12, 8%, p=0 x 04). Having a funeral and keeping mementoes were not associated with further adverse outcomes, but small numbers limited interpretation.Interpretation Our findings do not support good-practice guidelines, which state that failure to see and hold the dead child could have adverse effects on parents' mourning.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“It has been found that women who hold their deceased infant have significantly higher rates of post-traumatic stress disorder (PTSD), anxiety, and depression even 7 years after the event.30,31”
From Complicated grief after perinatal loss (2012) · cites this paper as [31]
In the citing paper
“however, a study25 published in 2002 showed increased maternal depression and anxiety associated with seeing and holding the deceased baby in a dose-response-like trend.”
From Bereavement care guidelines used in health care facilities immediately following perinatal loss: a scoping review (2024) · cites this paper as [25]
In the citing paper
“Parents’ mental health outcomes related to making meaning/memories were documented in 29 reports,17,25,53,54,58,60,63,64,69,70,76,86,89,98,103,107,110,111,116,119,121,122,127,137–139,148,149,154 and included coping, anxiety, and depression.”
From Bereavement care guidelines used in health care facilities immediately following perinatal loss: a scoping review (2024) · cites this paper as [25]
In the citing paper
“Additionally, there were a small number of studies (n=7) that indicated seeing the baby had positively influenced coping, while holding the baby did not.”
From Bereavement care guidelines used in health care facilities immediately following perinatal loss: a scoping review (2024) · cites this paper as [25]
In the citing paper
“A few studies (n=5) indicated that seeing the baby was perceived negatively,25,72,163,184,201 or were inconclusive (n=3)55,80,125 in terms of influence on parents’ mental health outcomes.”
From Bereavement care guidelines used in health care facilities immediately following perinatal loss: a scoping review (2024) · cites this paper as [25]
In the citing paper
“This need for recognition was reported as inadequately met, which reportedly affected parents’ outlook.”
From Bereavement care guidelines used in health care facilities immediately following perinatal loss: a scoping review (2024) · cites this paper as [25]
In the citing paper
“Sixty-nine reports included perinatal loss involving 1 or more babies of a twin or multiple pregnancy20,25–28,33,46,47,49,53–56,58,60,61,64–66,68,72,74,76,77,79,80,82,91,100,102,103,106,107,109–116,120–122,128,131,145,150,152,154,160,161,166,169,176,179,180,182,186,188,197,200,205,209,212,214,220,223,225 indicated that additional bereavement care considerations are needed.”
From Bereavement care guidelines used in health care facilities immediately following perinatal loss: a scoping review (2024) · cites this paper as [25]
In the citing paper
“Fifty-one reports identified an association between emotional and social support, which was associated with mental health outcomes of coping, well-being, healing, PTSD, trauma symptoms, anxiety, depression, emotional distress, helplessness, anger, and loneliness.”
From Bereavement care guidelines used in health care facilities immediately following perinatal loss: a scoping review (2024) · cites this paper as [25]
In the citing paper
“Fifty-nine reports indicated that parents desired shared decision-making and greatly appreciated it; however, shared decision-making was inconsistently practiced.”
From Bereavement care guidelines used in health care facilities immediately following perinatal loss: a scoping review (2024) · cites this paper as [25]
In the citing paper
“The guidelines for bereavement support after stillbirth that do exist require additional empirical data about what parents want or would find most meaningful and effective”
From Silent loss and the clinical encounter: Parents’ and physicians’ experiences of stillbirth–a qualitative analysis (2012) · cites this paper as [25]
In the citing paper
“One important but small study raised doubts about the effectiveness of such approaches in helping parents recover; results suggested that holding or even seeing one’s stillborn baby was associated with higher rates of long-term depression and post-traumatic stress [25].”
From Silent loss and the clinical encounter: Parents’ and physicians’ experiences of stillbirth–a qualitative analysis (2012) · cites this paper as [25]
Citations
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,845
An inventory for measuring depression
BECK, A. T. (1961) · Archives of General Psychiatry · doi:10.1001/archpsyc.1961.01710120031004 · Cited by 38,032
Detection of Postnatal Depression: Development of the 10-item Edinburgh Postnatal Depression Scale
Cox, J. L., Holden, J. M., & Sagovsky, R. (1987) · British Journal of Psychiatry · doi:10.1192/bjp.150.6.782 · Cited by 14,183
(1978) · Medical Entomology and Zoology · Cited by 12,570
Attachment in the preschool years: Theory, research, and intervention.
Greenberg, M. T., Cicchetti, D., & Cummings, E. M. (1990) · University of Chicago Press eBooks · Cited by 2,161
Confidence intervals rather than P values: estimation rather than hypothesis testing.
Gardner, M. J., & Altman, D. G. (1986) · BMJ · doi:10.1136/bmj.292.6522.746 · Cited by 2,014
Main, M., & Solomon, J. (2026) · Routledge eBooks · doi:10.4324/9781003569978-2 · Cited by 1,978
Disorganized attachment in early childhood: Meta-analysis of precursors, concomitants, and sequelae
VAN IJZENDOORN, M. H., SCHUENGEL, C., & BAKERMANS–KRANENBURG, M. J. (1999) · Development and Psychopathology · doi:10.1017/s0954579499002035 · Cited by 1,625
Screening for depression during pregnancy with the edinburgh depression scale (EDDS)
Murray, D., & Cox, J. L. (1990) · Journal of Reproductive and Infant Psychology · doi:10.1080/02646839008403615 · Cited by 973
Stillbirth as risk factor for depression and anxiety in the subsequent pregnancy: cohort study
Hughes, P. M., Turton, P., & Evans, C. D. H. (1999) · BMJ · doi:10.1136/bmj.318.7200.1721 · Cited by 260
Self-citationTurton, P., Hughes, P., Evans, C. D. H., & Fainman, D. (2001) · British Journal of Psychiatry · doi:10.1192/bjp.178.6.556 · Cited by 254
Self-citationSupport after perinatal death: a study of support and counselling after perinatal bereavement
Forrest, G. C., Standish, E., & Baum, J. D. (1982) · BMJ · doi:10.1136/bmj.285.6353.1475 · Cited by 221
Radestad, I., Steineck, G., Nordin, C., & Sjogren, B. (1996) · BMJ · doi:10.1136/bmj.312.7045.1505 · Cited by 204
Cain, A. C., & Cain, B. S. (1964) · Journal of the American Academy of Child Psychiatry · doi:10.1016/s0002-7138(09)60158-8 · Cited by 194
Validation of an Inventory for Measuring Depression
Metcalfe, M., & Goldman, E. (1965) · The British Journal of Psychiatry · doi:10.1192/bjp.111.472.240 · Cited by 186
Prenatal and perinatal influences on risk for psychopathology in childhood and adolescence
Allen, N. B., Lewinsohn, P. M., & Seeley, J. R. (1998) · Development and Psychopathology · doi:10.1017/s0954579498001722 · Cited by 180
Disorganised Attachment Behaviour among Infants Born Subsequent to Stillbirth
Hughes, P. M., Turton, P., Hopper, E. I., McGauley, G., & Fonagy, P. (2001) · Journal of Child Psychology and Psychiatry · doi:10.1111/1469-7610.00776 · Cited by 148
Self-citationLeeds, M. (1977) · PubMed · Cited by 140
THE MANAGEMENT OF STILLBIRTH COPING WITH AN UNREALITY
Lewis, E. (1976) · The Lancet · doi:10.1016/s0140-6736(76)90680-2 · Cited by 130
Mourning by the family after a stillbirth or neonatal death.
Lewis, E. (1979) · Archives of Disease in Childhood · doi:10.1136/adc.54.4.303 · Cited by 116
Oakley, A. (1984) · Cited by 112
Satisfaction with hospital care and interventions after pregnancy loss
Lasker, J. N., & Toedter, L. J. (1994) · Death Studies · doi:10.1080/07481189408252642 · Cited by 105
The “replacement child”: A saga of unresolved parental grief
Olmsted, R. W., & Poznanski, E. O. (1972) · The Journal of Pediatrics · doi:10.1016/s0022-3476(72)80261-0 · Cited by 103
Thompson, S. G., Pyke, S., & Hardy, R. (1997) · Statistics in Medicine · doi:10.1002/(sici)1097-0258(19970930)16:18 · Cited by 99
Failure to mourn a stillbirth: An overlooked catastrophe
Lewis, E., & Page, A. (1978) · British Journal of Medical Psychology · doi:10.1111/j.2044-8341.1978.tb02468.x · Cited by 96
Miscarriage and stillbirth: time since the loss, grief intensity and satisfaction with care
Cuisinier, M. C. J., Kuijpers, J. C., Hoogduin, C. A. L., de Graauw, C. P. H. M., & Janssen, H. J. E. M. (1993) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/0028-2243(93)90066-l · Cited by 95
Black/white IQ differences: Does age make the difference?
Vincent, K. R. (1991) · Journal of Clinical Psychology · doi:10.1002/1097-4679(199103)47:2 · Cited by 45
Parental behavior after perinatal death: twelve years of observations
Rand, C. S. W., Kellner, K. R., Revak-Lutz, R., & Massey, J. K. (1998) · Journal of Psychosomatic Obstetrics & Gynecology · doi:10.3109/01674829809044220 · Cited by 34
Delayed psychological effects of perinatal deaths: the next pregnancy and the next generation.
Bourne, S., & Lewis, E. (1984) · BMJ · doi:10.1136/bmj.289.6438.147 · Cited by 24
Parental Reactions to Stillbirth
COOPER, J. D. (1980) · The British Journal of Social Work · doi:10.1093/oxfordjournals.bjsw.a054495 · Cited by 18
Family Reactions to Child Bereavement
Jolly, H. (1976) · Proceedings of the Royal Society of Medicine · doi:10.1177/003591577606901124 · Cited by 15
Family reactions to stillbirth.
Jolly, H. (1976) · Europe PMC (PubMed Central) · Cited by 2
Cited by
Sorted by citations
Himelstein, B. P., Hilden, J. M., Boldt, A. M., & Weissman, D. E. (2004) · New England Journal of Medicine · doi:10.1056/nejmra030334 · Cited by 570
Etiology and prevention of stillbirth
Fretts, R. C. (2005) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2005.03.074 · Cited by 462
Complicated grief after perinatal loss
Kersting, A., & Wagner, B. (2012) · Dialogues in Clinical Neuroscience · doi:10.31887/dcns.2012.14.2/akersting · Cited by 419
“It has been found that women who hold their deceased infant have significantly higher rates of post-traumatic stress disorder (PTSD), anxiety, and depression even 7 years after the event.(30,31) It has been reported in these publications that women who hold their dead infant have significantly higher rates of depressi…”
BackgroundFrøen, J. F., Cacciatore, J., McClure, E. M., Kuti, O., Jokhio, A. H., Islam, M., & Shiffman, J. (2011) · The Lancet · doi:10.1016/s0140-6736(10)62232-5 · Cited by 356
Smith, G. C. S., & Fretts, R. C. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61723-1 · Cited by 292
Metadata
- Authors
- Hughes, P., Turton, P., Hopper, E., & Evans, C.
- Affiliations
- St George's Hospital (GB)
- Rampton Hospital (GB)
- Corresponding author
- Hughes, P
- ORCID
- Hopper, E
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2002-07
- Volume
- 360
- Issue
- 9327
- Pages
- 114-118
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2133400295
- Cited by
- 375
- References
- 32
- Citations by year
- 2026: 2 · 2025: 9 · 2024: 4 · 2023: 22 · 2022: 9 · 2021: 9 · 2020: 11 · 2019: 6 · 2018: 16 · 2017: 61 · 2016: 14 · 2015: 22 · 2014: 14 · 2013: 22 · 2012: 24
- FWCI
- 20.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Keywords
- stillbirth, psychosocial care, maternal depression, maternal anxiety, post-traumatic stress disorder, disorganized attachment, good practice guidelines, bereavement, funerals
- MeSH terms
- Adult, Female, Fetal Death, Grief, Humans, Psychosocial Deprivation, Cohort Studies, Case-Control Studies, Practice Guidelines as Topic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
