Hospital care for parents after perinatal death.
OBJECTIVE
To systematically review parent experiences with hospital care after perinatal death.


METHODS
An evaluation of more than 1,100 articles from 1966 to 2006 was performed to identify studies of fetal death in the second or third trimester and neonatal death in the first month of life.


METHODS
Studies were limited to those that were in English, evaluated care in U.S. hospitals, and contained direct parent data or opinions.


RESULTS
Results were compiled on five aspects of recommended care: 1) obtaining photographs and memorabilia of the deceased infant, 2) seeing and holding the infant, 3) labor and delivery of the child, 4) autopsies, and 5) options for funerals or memorial services. Sixty eligible studies with over 6,200 patients were reviewed. In general, parents reported appreciating time and contact with their deceased infant, being given options about labor, delivery, and burial, receiving photographs and memorabilia, and having appropriate hospital follow-up after autopsy.


CONCLUSIONS
Although care after perinatal death often adheres to published guidelines, substantial room for improvement is apparent. Parents with perinatal losses report few choices during labor and delivery and inadequate communication about burial options and autopsy results. Hospitals, nurses, and doctors should increase parental choice about timing and location of delivery and postpartum care, encourage parental contact with the deceased infant, and facilitate provision of photos and memorabilia.
Gold
Katherine J
KJ
Department of Family Medicine and Department of Internal Medicine, Robert Wood Johnson Clinical Scholars Program, University of Michigan, Ann Arbor, Michigan, USA. ktgold@umich.edu
Dalton
Vanessa K
VK
Schwenk
Thomas L
TL
D000223:Adaptation, Psychological; D000328:Adult; D001344:Autopsy; D001601:Bereavement; D002755:Choice Behavior; D005260:Female; D005313:Fetal Death; D005655:Funeral Rites; D006760:Hospitalization; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D010348:Patient Care Team; D010781:Photography; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D011263:Pregnancy Trimester, Third; D050497:Stillbirth / Q000523:psychology*