Coping with loss

Stillbirth is one of our society’s hidden nightmares. Though rarely discussed, even by health practitioners with parents-to-be, it is experienced by one in every 135 Australian families. Twice as many lives are lost to it each year as are taken in road fatalities, and 30 times more than by Sudden Infant Death Syndrome.

Not surprisingly, the experience is devastating for those affected. Besides having to cope with the inevitable grief, parents are also at heightened risk of depression and self-blame. A dangerous spiral that can be exacerbated by the fact that 30 to 50 per cent of stillbirths are unexplained, and health care workers are often poorly trained to provide an adequate level of care.

On this latter front, however, progress is now being made Australia-wide as a result of research conducted recently by the University of Adelaide.

In a project funded by the Stillbirth Foundation Australia, the research team conducted a worldwide review of studies into how families experience care after stillbirth, and then produced a series of best-practice guidelines for health practitioners. These guidelines are now freely available on the Stillbirth Foundation Australia website and have been embraced by health professionals and relevant industry bodies across the country.

“Quality of care is one area where we can make a huge and positive difference for families coping with stillbirth,” said Professor Zoe Jordan.

“Our research confirmed that the actions, behaviour and communications of health care professionals during their interaction with parents, and the stillborn baby, can have a considerable impact on parents’ psychological well-being.”

According to Professor Jordan, the research findings show that parents are most comforted by health care professionals who are prepared to involve them collaboratively in decision-making, and who provide empathetic, sensitive, culturally appropriate and respectful care at all times.

“In our guidelines we identify three key stages in the care process – from diagnosis to birth, immediately after birth, and post-birth onwards. Each stage is critical and may require unique information and support provision.

“For example, this can include guidance around such difficult issues as: what to expect from the delivery; how to arrange the induction and birth environment; whether or not to conduct an autopsy; holding, bathing and spending time with the baby, and so on.”

“We’re also advocating for its incorporation in an education program,” said Professor Jordan. “Our research confirms that health care professionals themselves can be emotionally affected by stillbirth, which can influence their interaction with parents. So it’s something they really need to prepare for.”