Navigating care after a baby dies: a systematic review of parent experiences with health providers.
BACKGROUND
Health care providers are on the front lines of care when a baby dies, but there is no consensus about which behaviors are most helpful or harmful for families.


METHODS
This systematic review of more than 1100 English-language articles from 1966 to 2006 addressed fetal and early infant loss and extracted information about interactions with health providers.


RESULTS
Sixty-one studies, covering over 6000 parents, met criteria. Nurses were generally viewed as more emotionally supportive than physicians. Parents valued emotional support, attention to mother and baby and grief education. Avoidance, insensitivity and poor staff communication were the most distressing behaviors encountered.


CONCLUSIONS
Interactions with health providers has profound effects on parents with perinatal losses. Grieving parents perceive many behaviors to be thoughtless or insensitive. Physicians and nurses may benefit from increased training in bereavement support.
Gold
K J
KJ
Department of Family Medicine, University of Michigan Health System, Ann Arbor, MI 48109-0604, USA. ktgold@umich.edu
D001601:Bereavement; D005313:Fetal Death; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D017283:Neonatal Nursing; D010290:Parents / Q000523:psychology*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011369:Professional-Patient Relations; D013398:Sudden Infant Death