Physicians' attitudes and advice concerning pregnancy subsequent to the birth of a stillborn child.
The aim of this study was to identify physicians' approaches to pregnancy subsequent to the birth of a stillborn child. In a 48-question, cross-sectional survey performed in 1997 one specific question dealt with advice given to the women/parents about possible subsequent pregnancy. The present study analyzes the responses to that open-ended question. Fifty-eight out of 61 Swedish hospitals with departments of obstetrics and gynecology participated in the study. Of 594 physicians, 552 answered the open-ended question (93%) with 802 items of advice. The most frequent approach to subsequent pregnancy, expressed by a majority of physicians, was their own support to the couples (59%). Regarding gender differences the females were more likely to mention support strategies than their colleagues (p = 0.005). Significantly more female gynecologists than male (p = 0.005) recommended care during the new pregnancy at a special antenatal clinic. The statement that 'advice depends on diagnosis' was made by 27%, while 22% advocated that parents first work through the grief of the stillbirth (mentioned significantly more often by females, p = 0.014). A minority of physicians mention giving specific advice about the timing of next pregnancy. The study highlights physicians' concerns to support parents through a subsequent pregnancy whilst demonstrating that considerable variation exists in their advice, or lack of it, with regard to timing of another pregnancy.
Department of Obstetrics and Gynecology, Danderyd Hospital, Sweden. karin.saflund@omv.ki.se
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Säflund
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Sjögren
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Wredling
D000328:Adult; D001291:Attitude of Health Personnel; D002055:Burnout, Professional / Q000523:psychology; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005260:Female; D005313:Fetal Death; D006801:Humans; D008297:Male; D008875:Middle Aged; D010290:Parents / Q000523:psychology; D010819:Physician's Role; D010817:Physician-Patient Relations; D011247:Pregnancy; D013548:Sweden