Parents’ experiences of care offered after stillbirth: An international online survey of high and middle-income countries
Open accessAbstract
BACKGROUND: Stillbirth, the death of a baby before birth, is associated with significant psychological and social consequences that can be mitigated by respectful and supportive bereavement care. The absence of high-level evidence to support the broad scope of perinatal bereavement practices means that offering a range of options identified as valued by parents has become an important indicator of care quality. This study aimed to describe bereavement care practices offered to parents across different high-income and middle-income countries. METHODS: An online survey of parents of stillborn babies was conducted between December 2014 and February 2015. Frequencies of nine practices were compared between high-income and middle-income countries. Differences in proportions of reported practices and their associated odds ratios were calculated to compare high-income and middle-income countries. RESULTS: Over three thousand parents (3041) with a self-reported stillbirth in the preceding five years from 40 countries responded. Fifteen countries had atleast 40 responses. Significant differences in the prevalence of offering nine bereavement care practices were reported by women in high-income countries (HICs) compared with women in middle-income countries (MICs). All nine practices were reported to occur significantly more frequently by women in HICs, including opportunity to see and hold their baby (OR = 4.8, 95% CI 4.0-5.9). The widespread occurrence of all nine practices was reported only for The Netherlands. CONCLUSIONS: Bereavement care after stillbirth varies between countries. Future research should look at why these differences occur, their impact on parents, and whether differences should be addressed, particularly how to support effective communication, decision-making, and follow-up care.
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Many memory making activities discussed by parents in this study (spending time with baby, taking/asking for photos, naming baby) are commonly reported in bereavement literature.
“Many of the memory making activities discussed by parents in this study such as spending time with their baby, taking/asking for photos, and naming their baby, are commonly reported in bereavement literature (10, 25).”
From Parent hospital experiences following stillbirth (2026) · cites this paper as [25]
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- Authors
- Horey, D., Boyle, F. M., Cassidy, J., Cassidy, P. R., Erwich, J. J. H. M., Gold, K. J., Gross, M. M., Heazell, A. E. P., Leisher, S. H., Murphy, M., Ravaldi, C., Siassakos, D., Storey, C., Vannacci, A., Wojcieszek, A., & Flenady, V.
- Affiliations
- La Trobe University (AU)
- The University of Queensland (AU)
- Asociación Umamanita Girona Spain
- Universidad Complutense de Madrid (ES)
- University Medical Center Groningen (NL)
- University of Michigan (US)
- Medizinische Hochschule Hannover (DE)
- University of Manchester (GB)
- International Stillbirth Alliance Millburn NJ USA
- University College Cork (IE)
- University of Florence (IT)
- University College London (GB)
- International Stillbirth Alliance Bristol UK
- National Health and Medical Research Council (AU)
- Corresponding author
- Horey, Dell
- ORCID
- Venue
- Birth
- Publisher
- Wiley
- Published
- 2021-03-18
- Volume
- 48
- Issue
- 3
- Pages
- 366-374
- ISSN
- 0730-7659 (ISSN-L)
- 1523-536X
- OpenAlex
- W3135197601
- Cited by
- 44
- References
- 28
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 10 · 2023: 11 · 2022: 8 · 2021: 1
- FWCI
- 5.11
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Birth (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Figshare (submittedVersion)
- Florence Research (University of Florence) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- La Trobe University
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
- Keywords
- stillbirth, perinatal bereavement, bereavement support, parental experiences, high-income countries, middle-income countries, cross-national comparison
- MeSH terms
- Bereavement, Developing Countries, Female, Humans, Parents, Pregnancy, Surveys and Questionnaires, Stillbirth
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