Parents’ experiences and expectations of care in pregnancy after stillbirth or neonatal death: a metasynthesis
Article first published online: 4 MAR 2014
© 2014 Royal College of Obstetricians and Gynaecologists
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 121, Issue 8, pages 943–950, July 2014
How to Cite
Parents’ experiences and expectations of care in pregnancy after stillbirth or neonatal death: a metasynthesis. BJOG 2014;121:943–950., , , , , .
- Issue published online: 24 JUN 2014
- Article first published online: 4 MAR 2014
- Manuscript Accepted: 6 DEC 2013
- neonatal death;
- perinatal loss;
- subsequent pregnancy
Pregnancy after perinatal death is characterised by elevated stress and anxiety, increasing the risk of adverse short-term and long-term outcomes.
This metasynthesis aimed to improve understanding of parents’ experiences of maternity care in pregnancy after stillbirth or neonatal death.
Six electronic databases were searched using predefined search terms.
English language studies using qualitative methods to explore the experiences of parents in pregnancy after perinatal loss, were included subject to quality appraisal framework.
Data collection and analysis
Searches were initiated in December 2011 and finalised in March 2013. Studies were synthesised using an interpretive approach derived from meta-ethnography.
Fourteen studies were included in the synthesis, graded A (no or few flaws, high trustworthiness; n = 5), B (some flaws, unlikely to affect trustworthiness; n = 5) and C (some flaws, possible impact on trustworthiness; n = 4). Three main themes were identified; co-existence of emotions, helpful and unhelpful coping activities and seeking reasssurance through interactions.
Parents’ experiences of pregnancy are profoundly altered by previous perinatal death; conflicted emotions, extreme anxiety, isolation and a lack of trust in a good outcome are commonly reported. Emotional and psychological support improves parents’ experiences of subsequent pregnancy, but the absence of an evidence base may limit consistent delivery of optimal care within current services.