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Cited by 110Grief, Bereavement, and Mental HealthGlobal Maternal and Child HealthMaternal and Perinatal Health Interventions

The Silent Child—Mothers’ Experiences Before, During, and after Stillbirth

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Trulsson, Otti, Rådestad, Ingela·2004·Birth
DOI 10.1111/j.0730-7659.2004.00304.x
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Abstract

Abstract: Background: The quality of care received by a woman who gives birth to a dead baby is crucial for her long‐term well‐being, and limiting the period between diagnosis of intrauterine death and induction of delivery decreases her anxiety risk. The primary objective of this study was to explore why induction of delivery for most women should not be delayed more than 24 hours from the diagnosis of intrauterine death. A secondary objective was to determine how the time between diagnosis and delivery should be spent. Methods: Twelve women were interviewed about their experience before and during the diagnosis of their baby's death and the event of birth. Interviews took place 6 to 18 months after the delivery and were analyzed using a phenomenological methodology. Results: Women experienced premonition, difficulty communicating their worry, cessation of verbal communication with staff, unreality and numbing, desire to get rid of the dead child immediately, going through childbirth, and total silence. Many women believed that they were not respected as a human being during the process of diagnosing the intrauterine death. Themes emerged indicating caregivers should not reduce to zero the time between diagnosis of intrauterine death and induction of delivery. Time may be needed to obtain medical information about the delivery and to prepare the woman for meeting with and saying goodbye to her long‐awaited but now silent baby. Conclusion: The period between diagnosis of intrauterine death and induction of delivery may give health professionals a major opportunity to improve a woman's ability to cope with the event of stillbirth and prepare her to meet with her loved but now silent baby. Further clinical research can identify supportive mechanisms for parents, and sources of iatrogenic psychological trauma that should be eliminated.

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  • Support and information from staff may help parents who feel emotionally unprepared for a vaginal birth (FES 23%).

    “Support and information from staff may help parents who feel emotionally unprepared for a vaginal birth, FES 23 % [21, 32, 33, 37, 46–48, 51, 58]”

    From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [48]

    In “The delivery,” women describe feeling unprepared for vaginal birth and receiving an explanation from staff. “Discussion and Conclusions” says some needed time and medical information to prepare psychologically. The paper supports the suggested value of information, but its interviews concern mothers, and it does not report an FES measure or a 23% figure. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Continuity of care and carer is important to parents (FES 15%).

    “Continuity of care and carer is important to parents, FES 15 % [34, 37, 40, 41, 46, 48]”

    From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [48]

    In “Before the Birth” (page unavailable), a woman valued being received by the same midwife she had met the previous day, while three women described distressing care involving several doctors and midwives. This supports the importance of continuity for mothers experiencing stillbirth, but the paper does not report an FES of 15% or establish the finding for parents generally. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • Parents have a range of emotions and reactions because stillbirth is a life changing event (FES 18%).

    “Parents have a range of emotions and reactions because stillbirth is a life changing event, FES 18 % [33, 36, 37, 46–48]”

    From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [48]

    The Before the Birth section describes mothers’ varied reactions to learning their baby had died, including numbness, anger, sorrow, fear and disbelief. This supports the point about a range of emotions, but the study interviewed mothers rather than parents generally and does not characterize stillbirth as a “life changing event.” The cited paper does not establish the FES 18% figure. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Previous qualitative research has investigated the experience of induction of labour, the role of caregivers and the experiences of women accessing bereavement support after stillbirth.

    “Previous qualitative research has investigated the experience of induction of labour, the role of caregivers and the experiences of women accessing bereavement support after stillbirth.16–18”

    From Bereaved parents’ experience of stillbirth in UK hospitals: a qualitative interview study (2013) · cites this paper as [17]

    The Abstract and Before the Birth section describe qualitative interviews about induction of labour and women’s interactions with caregivers. The Discussion and Conclusions also addresses caregivers’ support around meeting and saying goodbye to the baby. Our copy does not show an investigation of women’s experiences accessing bereavement support after stillbirth, so that part of the sentence is not supported by this source. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Many parents suspected something was wrong with their baby prior to presentation and described how their symptoms were not always taken seriously by healthcare professionals.

    “Many parents suspected something was wrong with their baby prior to presentation and described how their symptoms were not always taken seriously by healthcare professionals.”

    From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [48]

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Cites

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Research works printed but not linked: 3

  1. Laurell-Borulf Y. Long-Term Adjustment After an Emotional Crisis-A Follow-Up of Women with a Perinatal Death Infant. Doctoral dissertation. Lund, Sweden: Studentlitteratur, 1982.
  2. Rand CS, Kellner KR, Revak-Lutz R, Massey JK. Parental behaviour after perinatal death: Twelve years of observation. J Psychosom Obstet Gynaecol 1998;1:44-48.
  3. Tranter S, Martin D. Improving management of miscarriage and stillbirth through better organisation and greater sensitiv- ity. Mod Midwife 1994;5:28-29.

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Authors
Trulsson, O., & Rådestad, I.
Affiliations
Oslo University Hospital (NO)
Venue
Birth
Publisher
Wiley
Published
2004-08-27
Volume
31
Issue
3
Pages
189-195
ISSN
  • 0730-7659 (ISSN-L)
  • 1523-536X
DOI
10.1111/j.0730-7659.2004.00304.x
OpenAlex
W2033608754
Cited by
110
References
18
Citations by year
2025: 4 · 2024: 3 · 2023: 6 · 2022: 1 · 2021: 2 · 2020: 5 · 2019: 5 · 2018: 3 · 2017: 5 · 2016: 7 · 2015: 11 · 2014: 7 · 2013: 10 · 2012: 5
FWCI
3.65
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Birth (publishedVersion)
  • PubMed (publishedVersion)
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 › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords
stillbirth, intrauterine fetal death, labor induction, maternal experience, maternal grief, psychological trauma, caregiver-patient communication, delivery time, maternal well-being
MeSH terms
Adaptation, Psychological, Communication, Female, Fetal Death, Humans, Interprofessional Relations, Interviews as Topic, Labor, Induced, Norway, Pregnancy, Social Support, Time Factors

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