Care in subsequent pregnancies following stillbirth: An international survey of parents

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Table S1. Breakdown of responses by geographic region, country, and income-setting.
Date
2016-11-30
Authors
Wojcieszek, Aleena M.
Boyle, Frances M.
Belizán, Jose M.
Cassidy, Jillian
Cassidy, Paul
Erwich, Jan Jaap H. M.
Farrales, Lynn
Gross, Mechthild M.
Heazell, Alexander E. P.
Leisher, Susannah Hopkins
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John Wiley & Sons, Inc.
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Abstract
Objective: To assess the frequency of additional care, and parents' perceptions of quality, respectful care in pregnancies subsequent to stillbirth. Design: Multi-language web-based survey. Setting: International. Population: 2,716 parents, from 40 high- and middle-income countries. Methods: Data were obtained from a broader survey of parentsâ experiences of stillbirth. Data were analyzed using descriptive statistics and stratified by geographical region. Subgroup analyses explored variation in additional care by gestational age at index stillbirth. Main outcome measures: Frequency of additional care, and perceptions of quality, respectful care. Results: The majority (66%) of parents conceived their subsequent pregnancy within one year of stillbirth. Additional antenatal care visits and ultrasound scans were provided for 67% and 70% of all parents, respectively, although there was wide variation across geographical regions. Care addressing psychosocial needs was less frequently provided, such as visits to a bereavement counsellor (10%) and access to named care provider's phone number (27%). Compared to parents whose stillbirth occurred at 29 weeks' gestation or less, parents whose stillbirth occurred at 30 weeksâ gestation or greater were more likely to receive various forms of additional care, particularly the option for early delivery after 37 weeks. Around half (47-63%) of all parents felt that elements of quality, respectful care were consistently applied, such as spending enough time with parents and involving parents in decision-making. Conclusions: Care in pregnancies subsequent to stillbirth appears inconsistent. Greater attention is required to providing thoughtful, empathic, and collaborative care in all pregnancies following stillbirth. Training for health professionals is needed.
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Keywords
Stillbirth , Subsequent pregnancy , Management , Recurrence , Psychosocial/psychology , Epidemiology
Citation
Wojcieszek, A. M., Boyle, F. M., Belizán, J. M., Cassidy, J., Cassidy, P., Erwich, J. J. H. M., Farrales, L., Gross, M. M., Heazell, A. E. P., Leisher, S. H., Mills, T., Murphy, M., Pettersson, K., Ravaldi, C., Ruidiaz, J., Siassakos, D., Silver, R. M., Storey, C., Vannacci, A., Middleton, P., Ellwood, D. and Flenady, V. (2016) 'Care in subsequent pregnancies following stillbirth: An international survey of parents', BJOG: An International Journal of Obstetrics and Gynaecology, 125(2), pp. 193-201. doi: 10.1111/1471-0528.14424
Copyright
© 2016, Royal College of Obstetricians and Gynaecologists. This is the peer reviewed version of the following article: [Wojcieszek, A. M., Boyle, F. M., Belizán, J. M., Cassidy, J., Cassidy, P., Erwich, J. J. H. M., Farrales, L., Gross, M. M., Heazell, A. E. P., Leisher, S. H., Mills, T., Murphy, M., Pettersson, K., Ravaldi, C., Ruidiaz, J., Siassakos, D., Silver, R. M., Storey, C., Vannacci, A., Middleton, P., Ellwood, D. and Flenady, V. (2016) 'Care in subsequent pregnancies following stillbirth: An international survey of parents', BJOG: An International Journal of Obstetrics and Gynaecology, 125(2), pp. 193-201. doi: 10.1111/1471-0528.14424], which has been published in final form at [ https://doi.org/10.1111/1471-0528.14424]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.