Seeing and holding baby: Systematic review of clinical management and parental outcomes following stillbirth

Abstract

Background - In 2009 there were an estimated 2.6 million stillbirths worldwide. In the United States, a 2007 systematic review found little consensus about professional behaviours perceived by parents to be most helpful or most distressing. In the United Kingdom a bereaved parents’ organisation has highlighted discordance between parental views and clinical guidelines that recommend clinicians’ do not encourage parents to see and hold their baby. The objective of this review was to identify and synthesise available research reporting parental outcomes relating to seeing and holding.
Method(s) - We undertook a systematic review. We included studies of any design, reporting parental experiences and outcomes. Electronic searches (PubMed, PsychINFO) were conducted in January 2014. Three authors independently screened and assessed the quality of the studies, before abstracting data and undertaking thematic analysis.
Results - We reviewed 741 records and included 23 studies (10 quantitative,12 qualitative,1 mixed-method). Twenty-one studies suggested positive outcomes for parents who saw or held their baby. Increased psychological morbidity was associated with current pregnancy, choice not to see their baby, lack of time with their baby and/or insufficient mementos. Three themes were formulated “Positive effects of contact within a traumatic life event”, “Importance of role of health professionals”; and “Impact on Mothers and Fathers: Similarities and differences”.
Conclusions - Stillbirth is a risk factor for increased psychological morbidity. Parents’ seeing and holding their stillborn baby can be beneficial to their future wellbeing. Since 2007, there has been a proliferation of studies that challenge clinical guidelines recommending clinicians do not encourage parental contact.