Parents’ experiences and expectations of care in pregnancy after stillbirth or neonatal death: a metasynthesis
Abstract
Background: Pregnancy after perinatal death is characterised by elevated stress and anxiety, increasing the risk of adverse short‐term and long‐term outcomes. Objectives: This metasynthesis aimed to improve understanding of parents’ experiences of maternity care in pregnancy after stillbirth or neonatal death. Search strategy: Six electronic databases were searched using predefined search terms. Selection criteria: English language studies using qualitative methods to explore the experiences of parents in pregnancy after perinatal loss, were included subject to quality appraisal framework. Data collection and analysis: Searches were initiated in December 2011 and finalised in March 2013. Studies were synthesised using an interpretive approach derived from meta‐ethnography. Main results: Fourteen studies were included in the synthesis, graded A (no or few flaws, high trustworthiness; n = 5), B (some flaws, unlikely to affect trustworthiness; n = 5) and C (some flaws, possible impact on trustworthiness; n = 4). Three main themes were identified; co‐existence of emotions, helpful and unhelpful coping activities and seeking reasssurance through interactions. Conclusion: Parents’ experiences of pregnancy are profoundly altered by previous perinatal death; conflicted emotions, extreme anxiety, isolation and a lack of trust in a good outcome are commonly reported. Emotional and psychological support improves parents’ experiences of subsequent pregnancy, but the absence of an evidence base may limit consistent delivery of optimal care within current services.
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Experiences within the healthcare system following pregnancy loss or neonatal death have been established as fundamental to shaping bereaved parents' grief experience.
“Finally, at the system/policy level, experiences within the healthcare system following pregnancy loss or neonatal death have been established as fundamental to shaping bereaved parents’ grief experience [4, 9, 42].”
From Factors contributing to men’s grief following pregnancy loss and neonatal death: further development of an emerging model in an Australian sample (2021) · cites this paper as [4]
Including women from the community as a control group may contribute to inaccuracies, as the level of depression and anxiety among this group is not related to gestational outcome.
“Including women from the community as a control group may also contribute to inaccuracies (Mills et al., 2014), as the level of depression and anxiety among this group is not related to gestational outcome (either adverse or positive).”
From The mental health impact of perinatal loss: A systematic review and meta-analysis (2022) · cites this paper as Mills et al., 2014
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- Authors
- Mills, T., Ricklesford, C., Cooke, A., Heazell, A., Whitworth, M., & Lavender, T.
- Affiliations
- School of Nursing, Midwifery and Social Work The University of Manchester Manchester UK
- Central Manchester University Hospitals NHS Trust Manchester UK
- University of Manchester (GB)
- Manchester Academic Health Science Centre (GB)
- ORCID
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 2014-03-04
- Volume
- 121
- Issue
- 8
- Pages
- 943-950
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- 1471-0528
- OpenAlex
- W2000231544
- Cited by
- 155
- References
- 40
- Citations by year
- 2026: 13 · 2025: 11 · 2024: 12 · 2023: 13 · 2022: 20 · 2021: 15 · 2020: 12 · 2019: 11 · 2018: 13 · 2017: 10 · 2016: 12 · 2015: 11 · 2014: 2
- FWCI
- 1.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- Funders
- Tommy's Baby Charity
- 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 › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- neonatal death, perinatal loss, parental experiences, obstetric care, parental anxiety, coping, emotional support, parental isolation, expectant management
- MeSH terms
- Abortion, Spontaneous, Adaptation, Psychological, Adult, Anxiety, Counseling, Emotions, Female, Humans, Male, Maternal Health Services, Parents, Pregnancy, Stress, Psychological, Maternal-Fetal Relations, Qualitative Research, Stillbirth, Secondary Prevention
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