Stillbirth and perinatal care: Are professionals trained to address parents' needs?. (September 2018)

• Record Type: Journal Article
• Authors: Ravaldi, Claudia; Levi, Miriam; Angeli, Elena; Romeo, Gianpaolo; Biffino, Marco; Bonaiuti, Roberto; Vannacci, Alfredo
• Is Part Of: Midwifery. Volume 64(2018)
• Page Start: 53
• Page End: 59
• Publication Date: 2018-09
• Subjects: Stillbirth -- Care providers -- Midwives -- Perinatal bereavement care -- Guidelines; Midwifery -- Periodicals; Midwifery -- Periodicals; Sages-femmes -- Périodiques; Midwifery; Periodicals; Electronic journals; 618.2005
• DOI: 10.1016/j.midw.2018.05.008
• Languages: English
• ISSNs: 0266-6138

Abstract

Highlights: International guidelines for stillbirth care are scarcely applied in Italy and are largely ignored by healthcare staff. Inappropriate practices such as immediate delivery and sedation are still recommended by half practitioners interviewed. Half professionals still take stillborn babies immediately away and one third do not consider helpful to create memories. Abstract: Objective: To assess current practices of health care providers (HCPs) caring for women experiencing a stillbirth and to explore their needs for training to better support bereaved families. Design: Nationwide cross-sectional survey. The main outcome measures were the evaluation of HCPs cognition, emotions and behaviours with regard to the care of women with a stillbirth care, as well as their compliance with international guidelines. Participants: 750 HCPs, in 11 Italian hospitals, were administered a multiple-choice questionnaire. Findings: The response rate was 89.9%; the majority (94.1%) were female, with a mean age of 37.6 (SD = 10.4) years. Midwives were the most represented (72.8%). Half of the respondents recommended immediate birth; only 55% routinely bathed and dressed stillborn babies for their parents to see, while 44.4% of HCPs immediately took the babies away without allowing parents to properly say goodbye to them. More than half felt inadequate and some even reported having failed to provide support to the family when caring for a woman with stillbirth in the past. The need for professional training courses was expressed by 90.2%, and three-quarters had never previously attended a course on perinatal bereavement care. When answers by Italian HCPs are systematically evaluated with reference to international guidelines, the results were very poor with only 27.9% of respondents reported having created memories of the baby and less than 3% complied with all recommendations in the areas of respect for baby and parents, appropriate birth options, and aftercare. Key conclusions: There is a substantial gap between the standards of care defined by international guidelines and the practices currently in place in Italy. Italian HCPs feel an urgent need to be offered professional training courses to better meet the needs of grieving families. Implication for practice: Perinatal HCPs should be aware of their pivotal role in helping bereaved parents after stillbirth and perinatal loss, and seek appropriate training.