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      Is it possible for parents to endure a stillbirth? Initial experiences, perceptions and strategies: individual in-depth interviews in Sweden 2021–2023

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          Abstract

          Background

          Stillbirth occurs at a rate of 3.0 per thousand in Sweden. However, few studies have focused on the initial experiences of parents facing a stillbirth. The aim of this qualitative study is to deepen and broadly explore parents’ initial experiences, perceptions, internal processes and strategies from the moment of suspicion or awareness of stillbirth until one month after the event.

          Methods

          Ten individual in-depth interviews were conducted between 2021 and 2023, and data were evaluated using thematic network analysis.

          Results

          Two key themes emerged: ‘ Following the journey – from suspicion to acceptance’ and ‘ Support, structured activities and processes after stillbirth’. These themes captured the significant consequences of a sudden, unexpected and devastating end to pregnancy. The suspicion and eventual diagnosis of stillbirth were initially associated with sudden discomfort, fear, overwhelming grief, and intense pain. Nevertheless, a vaginal birth was regarded as the optimal mode of delivery for both physical and emotional wellbeing. Caring for the stillborn baby through physical proximity for an extended period of time helped parents comprehend and cope with their grief, while also affirming their sense of parenthood.

          Conclusions

          This study sheds light on the profound and devastating impact of stillbirth on parents who are confronted with the loss of their long-awaited and cherished baby. The intense grief and pain experienced by parents during the first month after stillbirth were described as an ongoing heavy burden, persisting day and night, and reflected in poor/very poor mental health. Despite the immense challenges faced by parents, the study highlights the importance of developing individual coping strategies to deal with this tragic and irreversible life-changing event.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12884-024-07055-0.

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          Most cited references26

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          Thematic networks: an analytic tool for qualitative research

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            But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation

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              From grief, guilt pain and stigma to hope and pride – a systematic review and meta-analysis of mixed-method research of the psychosocial impact of stillbirth

              Background Despite improvements in maternity healthcare services over the last few decades, more than 2.7 million babies worldwide are stillborn each year. The global health agenda is silent about stillbirth, perhaps, in part, because its wider impact has not been systematically analysed or understood before now across the world. Our study aimed to systematically review, evaluate and summarise the current evidence regarding the psychosocial impact of stillbirth to parents and their families, with the aim of improving guidance in bereavement care worldwide. Methods Systematic review and meta-summary (quantitative aggregation of qualitative findings) of quantitative, qualitative, and mixed-methods studies. All languages and countries were included. Results Two thousand, six hundred and nineteen abstracts were identified; 144 studies were included. Frequency effect sizes (FES %) were calculated for each theme, as a measure of their prevalence in the literature. Themes ranged from negative psychological symptoms post bereavement (77 · 1) and in subsequent pregnancies (27 · 1), to disenfranchised grief (31 · 2), and incongruent grief (28 · 5), There was also impact on siblings (23 · 6) and on the wider family (2 · 8). They included mixed-feelings about decisions made when the baby died (12 · 5), avoidance of memories (13 · 2), anxiety over other children (7 · 6), chronic pain and fatigue (6 · 9), and a different approach to the use of healthcare services (6 · 9). Some themes were particularly prominent in studies of fathers; grief suppression (avoidance)(18 · 1), employment difficulties, financial debt (5 · 6), and increased substance use (4 · 2). Others found in studies specific to mothers included altered body image (3 · 5) and impact on quality of life (2 · 1). Counter-intuitively, Some themes had mixed connotations. These included parental pride in the baby (5 · 6), motivation for engagement in healthcare improvement (4 · 2) and changed approaches to life and death, self-esteem, and own identity (25 · 7). In studies from low/middle income countries, stigmatisation (13 · 2) and pressure to prioritise or delay conception (9) were especially prevalent. Conclusion Experiencing the birth of a stillborn child is a life-changing event. The focus of the consequences may vary with parent gender and country. Stillbirth can have devastating psychological, physical and social costs, with ongoing effects on interpersonal relationships and subsequently born children. However, parents who experience the tragedy of stillbirth can develop resilience and new life-skills and capacities. Future research should focus on developing interventions that may reduce the psychosocial cost of stillbirth. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-0800-8) contains supplementary material, which is available to authorized users.
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                Author and article information

                Contributors
                berit.hoglund@kbh.uu.se
                Journal
                BMC Pregnancy Childbirth
                BMC Pregnancy Childbirth
                BMC Pregnancy and Childbirth
                BioMed Central (London )
                1471-2393
                3 January 2025
                3 January 2025
                2025
                : 25
                : 4
                Affiliations
                [1 ]Department of Women’s and Children’s Health, Uppsala University, ( https://ror.org/048a87296) Uppsala, 751 85 Sweden
                [2 ]Department of Nursing, Mid Sweden University, ( https://ror.org/019k1pd13) Sundsvall, Sweden
                [3 ]Department of Nursing, Umeå University, ( https://ror.org/05kb8h459) Umeå, Sweden
                Article
                7055
                10.1186/s12884-024-07055-0
                11699641
                39754069
                3910ad77-a8d0-4206-9ab3-aaef7f65a94f
                © The Author(s) 2025

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 11 June 2024
                : 9 December 2024
                Funding
                Funded by: Uppsala University
                Categories
                Research
                Custom metadata
                © BioMed Central Ltd., part of Springer Nature 2025

                Obstetrics & Gynecology
                coping strategies,foetal movements,grieving process,in-depth interviews,parents,professionals,stillbirth

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