Table 2 Comparison of Parents’ and Physicians’ Beliefs and Feelings
Practice Domain | Themes: Mothers/Parents | Themes: Physicians | |
|---|---|---|---|
1 | Knowledge/awareness | Believe that stillbirth happens more in low-resource countries. | Believe that stillbirth happens more in low-resource countries. |
Never expected this to happen and were shocked and unprepared. | NICUs are better prepared to handle deaths. | ||
Wanted to know the reason but no one could tell them the reason. | Except for obvious causes (cord/abruption), doctors often don’t know why stillbirths happen. | ||
2 | Hospital – environment | Being surrounded by reminders and sounds of healthy deliveries causes feelings of humiliation and anger on top of grief. | Believe that efforts are made to offer privacy and sensitive support. |
Overwhelmed, adding insult to injury, by having to explain (sometimes repeatedly) what happened to unprepared staff. | Accustomed to handing off patients (mother and infant) to a pediatrician or neonatologist. | ||
Appreciated the presence of physicians, social workers, and nurses who provided support to parents in grief and bereavement. | Most feeling unprepared to shift from role of physician to counselor. | ||
3 | Hospital – care & communication | Wanting physicians to engage them in their sadness and grief. | Wanting to suppress/hide sadness and grief to focus on finding out ‘why’ for the patient. |
Feeling shut out, not knowing. | Wanting to figure out the cause through tests or autopsy. | ||
Wanting answers but not strongly blaming self. | Wanting to reassure mothers in particular not to blame themselves. | ||
Holding someone responsible: Some blame the hospital or physician for not preventing the stillbirth. | Some worried about being blamed. | ||
4 | Rituals around death | Holding, bathing, dressing, photos, hand and footprints are important and preserve memories. However, should be offered, not forced. | Some offered death kits similar to those used in NICUs; others felt unfamiliar with what a parent might want and would defer to nursing staff. |
5 | Post-stillbirth care | Described grief as ambiguous—wanting to remember deeply sad memories. | Focused on reassurances about the future. Referrals to social work but few referrals to mental health professionals for follow-up care. |
Hunger for information on causes, prevention, and support resources. Few were offered this in hospital. | Typically make referrals to nursing or social work to offer information. | ||
Parent support groups and online groups helpful—someone who has gone through stillbirth and come out on the other side. | Not aware of these resources. | ||
6 | Post-stillbirth communication | This baby mattered to us and another baby will not replace her or make our feelings go away. | It is important to reassure mothers they did nothing wrong and can have another baby. |
7 | How stillbirth is perceived | A stillbirth is the death of a child. | A stillbirth is not as severe a loss as the death of a neonate. |
8 | Bereavement, remembrance, & recovery | We want to openly remember our baby as part of our family. | It is important to try to help them realize they have done nothing wrong and can go on to have another child. |