title: Seeing and Holding Baby: Systematic Review of Clinical Management and Parental Outcomes After 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 behaviors perceived by parents to be most helpful or most distressing. In the United Kingdom, a bereaved parents' organization 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 synthesize available research reporting parental outcomes relating to seeing and holding.
  
  
  METHODS
  We undertook a systematic review. We included studies of any design, reporting parental experiences and outcomes. Electronic searches (PubMed and 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, and 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 well-being. Since 2007, there has been a proliferation of studies that challenge clinical guidelines recommending that clinicians do not encourage parental contact.
authors.affiliation: School of Health, University of Central Lancashire, Preston, Lancashire, UK.
authors.forename: Carol
authors.initials: C
authors.lastname: Kingdon
authors.affiliation: Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Givens
authors.affiliation: Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
authors.forename: Emer
authors.initials: E
authors.lastname: O'Donnell
authors.affiliation: Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, Liverpool, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Turner
mesh_terms: D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D011247:Pregnancy; D012944:Social Support; D050497:Stillbirth / Q000453:epidemiology*; D014110:Touch / Q000502:physiology*
keywords: review; seeing and holding; stillbirth