Mothers’ access to supportive hospital services after the loss of a baby through stillbirth or neonatal death
Open accessAbstract
Every year, 3-5% of pregnant mothers in South Africa lose their babies to a stillbirth or neonatal death. These mothers need adequate services to prevent complications in their grieving process. Most of these babies are lost in hospital settings, so the treatment medical staff provide is vital. This study examined mothers’ experiences of accessing hospital, religious, formal and social services after a stillbirth or neonatal death. An exploratory research design was used to conduct applied research. A semi-structured interview schedule was used with a sample of 15 mothers who had lost a baby in the last 5 years. The findings were analysed quantitatively and qualitatively. The primary focus of this article is the quantitative findings relating to hospital services. The sample was small and these results cannot be generalised, but some conclusions are reached and recommendations are made to service providers in hospitals working with mothers who have lost babies. Mothers generally experienced the support services from hospitals as inadequate, compared to what hospitals could offer. Mothers that receive support after the loss of a baby generally cope better. This support thus assists them in the grieving process. Hospital staff can be trained to provide these services. Opsomming In Suid-Afrika verloor 3-5% swanger moeders hulle babas deur stilgeboorte of neonatale dood. Hierdie moeders benodig voldoende dienste om komplikasies in die rouproses te verhoed. Die behandeling deur mediese personeel is uiters belangrik omdat die meeste van dié babas in ‘n hospitaalopset sterf. Hierdie studie het moeders se ervarings van die toeganklikheid van hospitaal-, godsdienstige, formele en sosiale dienste na die dood van hulle babas deur stilgeboorte of neonatale dood ondersoek. Toegepaste navorsing is met behulp van ‘n verkennende navorsingsontwerp gedoen. ‘n Semi-gestruktureerde onderhoudskedule is gebruik met ‘n steekproef van 15 moeders wat hulle babas in die vorige 5 jaar verloor het. Die bevindinge is kwantitatief en kwalitatief ontleed. Hierdie artikel fokus primêr op die kwantitatiewe bevindinge wat op hospitaaldienste van toepassing is. Die steekproef was klein en bevindinge kan nie veralgemeen word nie, maar gevolgtrekkings en aanbevelings word gemaak vir diensverskaffers in hospitale wat met moeders werk wat hul babas verloor het. Respondente het die ondersteuningsdienste by hospitale oor die algemeen as onvoldoende ervaar in vergelyking met dít wat hospitale behoort aan te bied. Moeders wat wel ondersteuning na die verlies van ‘n baba ontvang, funksioneer oor die algemeen beter. Die ondersteuning help hulle in die rouproses. Hospitaalpersoneel kan opgelei word om hierdie dienste te verskaf.
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Clear, easily understandable and structured information given sensitively at appropriate times helps parents through their experience (FES 45%).
“Clear, easily understandable and structured information given sensitively at appropriate times, helps parents through their experience, FES 45 % [21, 31, 32, 34, 36, 37, 39–42, 44–51]”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [31]
In “Hospital services” (page not provided), the paper recommends accurate information about the cause of death and says ongoing communication enhances parents’ wellbeing. “Suggestions for improving services” calls for clarifying information and a structured procedure for supporting bereaved mothers, but does not specifically describe structured information delivered at appropriate times or report an FES of 45%. (LLM, conf=0.84)
Experimental — accuracy not yet measuredParents want privacy not abandonment (FES 30%).
“Parents want privacy not abandonment, FES 30 % [21, 31, 33–35, 37, 39, 41, 42, 46, 47, 51]”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [31]
The Hospital services section (page not specified) says all 15 mothers had their own rooms, while the Formal services section reports that 11 of 15 wanted an opportunity to see a hospital counsellor. Together these support privacy alongside continued support, but the paper does not report that parents explicitly wanted “privacy not abandonment” or a 30% FES. (LLM, conf=0.84)
Experimental — accuracy not yet measuredResearch and multiprofessional training is important for all staff to improve standards of bereavement care (FES 25%).
“Research and multiprofessional training is important for all staff to improve standards of bereavement care, FES 25 % [31, 35, 37, 38, 40, 52–56]”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [31]
The Conclusions and Recommendations section calls for better training for hospital staff, including all staff members involved with a bereaved mother. The Conclusion also calls for larger studies evaluating hospital services. The paper does not specify multiprofessional training or report an FES figure of 25%. (LLM, conf=0.86)
Experimental — accuracy not yet measuredParents wish for increased awareness and acknowledgement of stillbirth (FES 20%).
“Parents wish for increased awareness and acknowledgement of stillbirth, FES 20 % [21, 31, 37, 38, 47, 50, 57, 58]”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [31]
The ‘Services available to mothers after the death of a baby’ section calls for greater awareness of bereaved mothers’ needs and recognition of the significance of a baby’s death. It does not report that parents expressed this wish or associate the stated 20% with awareness or acknowledgement; the 20% figures in ‘Suggestions for improving services’ concern other requests. The indexed passages provide no page numbers. (LLM, conf=0.82)
Experimental — accuracy not yet measuredSome mothers who were sedated held regrets about the lost opportunity to be with their baby.
“Some mothers who were sedated held regrets about the lost opportunity to be with their baby.”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [31]
The Hospital services section reports that many mothers regretted not being able to hold their babies for longer. The Formal services section describes one mother who could not remember a counselling session because of medication, but it does not link medication or sedation to a lost opportunity to be with her baby. (LLM, conf=0.85)
Experimental — accuracy not yet measured
Parents who decide not to see and hold their baby often later regret this decision.
“Parents who decide not to see and hold their baby often later regret this decision.”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [31]
The Hospital services section says that shock can lead parents to make decisions about their baby that they later regret. It also reports that many interviewed mothers regretted not being able to hold their babies for longer. It does not establish that parents who choose not to see or hold their baby often regret that specific decision. (LLM, conf=0.86)
Experimental — accuracy not yet measuredParents would appreciate a healthcare system ready to provide emotional support following birth and discharge from hospital (FES 50%).
“Parents would appreciate a healthcare system ready to provide emotional support following birth and discharge from hospital, FES 50 % [21, 29, 31–38, 42, 43, 45–47, 50, 59, 63–65]”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [31]
The Formal services section reports that 11 of 15 bereaved mothers (73.3%) would have liked access to a hospital counsellor, and Suggestions for improving services calls for follow-up counselling after discharge. This supports the need for emotional support around a baby's death, but the study concerns bereaved mothers rather than parents generally and does not substantiate the stated FES 50% figure. (LLM, conf=0.85)
Experimental — accuracy not yet measuredClear care pathways are required at the interface between primary and secondary care (FES 5%).
“Clear care pathways are required at the interface between primary and secondary care, FES 5 % [31, 65]”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [31]
In “Suggestions for improving services” and “Conclusions and recommendations relating to hospital services” (page not provided), the paper calls for structured hospital procedures, follow-up after discharge, and referral for outside support. It does not specifically address care pathways at the interface between primary and secondary care. (LLM, conf=0.83)
Experimental — accuracy not yet measuredParents feel unprepared for the postnatal period and are unaware of their entitlements and the services available.
“Parents feel unprepared for the postnatal period and are unaware of their entitlements and the services available.”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [31]
The Formal services section reports that only five of fifteen mothers were given details of support structures, supporting the point that information about available services was often lacking. The paper studies mothers after stillbirth or neonatal death; it does not establish that parents generally feel unprepared for the postnatal period or are unaware of their entitlements. Page numbers are not available in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredA debriefing and follow-up appointment can help resolve uncertainty (FES 28%).
“A debriefing and follow-up appointment can help resolve uncertainty, FES 28 % [29, 31, 32, 35, 37, 39, 42, 46, 47, 50, 51]”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [31]
The Suggestions for improving services section recommends clarifying information for mothers and providing follow-up counselling after discharge, which supports the general idea of addressing uncertainty through follow-up. It does not describe a debriefing and follow-up appointment or report the cited FES 28% figure. Page numbers are unavailable in our copy. (LLM, conf=0.85)
Experimental — accuracy not yet measuredParents may regret certain decisions made regarding post-mortem and funeral arrangements (FES 10%).
“Parents may regret certain decisions made regarding post-mortem and funeral arrangements, FES 10 % [31, 35, 50, 53]”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [31]
The Hospital services section reports that one mother regretted the decision not to have an autopsy, supporting the post-mortem part of the claim. It recommends helping parents with funeral plans but does not report regret about funeral arrangements or an FES figure of 10%. Page numbers are unavailable in our copy. (LLM, conf=0.87)
Experimental — accuracy not yet measuredSpecialist bereavement staff and clear care pathways improved parents' and healthcare workers' experiences.
“Specialist bereavement staff and clear care pathways also improved parents’ and healthcare workers’ experiences [31, 68].”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [31]
In “Suggestions for improving services” (page unavailable), mothers recommend a structured procedure and a person trained to support bereaved mothers. The paper presents these as suggestions, not evidence that they improved parents’ experiences, and it does not assess healthcare workers’ experiences. (LLM, conf=0.86)
Experimental — accuracy not yet measuredParents who chose not to have a post-mortem were more likely to experience feelings of regret.
“parents who chose not to have a post-mortem were more likely to experience feelings of ‘regret’ [31, 35, 50, 53]”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [31]
The Hospital services section reports that no babies had autopsies and that one mother regretted that decision. It does not establish that parents who chose against a post-mortem were more likely to feel regret: it reports neither who made the decisions nor a comparison with parents who had post-mortems. (LLM, conf=0.88)
Experimental — accuracy not yet measuredBehaviours and actions of staff can have a memorable impact on parents (FES 53%).
“Behaviours and actions of staff can have a memorable impact on parents, FES 53 % [21, 29–48]”
From Systematic review to understand and improve care after stillbirth: a review of parents’ and healthcare professionals’ experiences (2016) · cites this paper as [31]
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- Authors
- Conry, J., & Prinsloo, C.
- Affiliations
- University of Pretoria (ZA)
- Venue
- Health SA Gesondheid
- Publisher
- AOSIS
- Published
- 2008-11-18
- Volume
- 13
- Issue
- 2
- Pages
- 14-24
- ISSN
- 1025-9848 (ISSN-L)
- 2071-9736
- OpenAlex
- W2149481464
- Cited by
- 18
- References
- 26
- Citations by year
- 2025: 1 · 2024: 2 · 2022: 1 · 2019: 1 · 2018: 1 · 2017: 1 · 2016: 2 · 2015: 6 · 2014: 2 · 2013: 1
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Health SA Gesondheid (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- UpSpace Institutional Repository (University of Pretoria) (submittedVersion)
- 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, neonatal death, maternal bereavement, grief, hospital support, maternal mental health, hospital staff training, religious support, social support, coping, South Africa, maternal mental health services
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