Date of Graduation

2012

Document Type

Dissertation/Thesis

Abstract

STATEMENT OF PROBLEM: Annually there are approximately 26,000 stillbirths in the United States. The loss of a child has the ability to derail life’s trajectory like no other loss, and stillbirth can significantly affect a woman’s relationships, her health, and future childbearing. Stillbirth interventions provided in the hospital are intended to provide comfort and support and assist women as they grieve. Stillbirth interventions have evolved over the last 30 years, but there have been no evaluations of interventions to determine if they were helpful to grieving mothers. This study, therefore, evaluated the impact of interventions provided at the time of stillbirth on maternal grief METHODS: Data collection was conducted online. The Internet presented an opportunity to reach a diverse group of women. After IRB approval, links to the survey were placed on approximately 30 websites. Inclusion criteria were women, ages 18 and over, who had experienced a stillbirth in the previous two years, and who were able to read and respond to the survey in English. While 943 women from 13 countries completed the survey, 498 met the inclusion criteria. Intervention data were collected as self-report data and the Perinatal Grief Scale (PGS) was used to collect data on maternal grief. Data were analyzed to describe the interventions and the maternal grief response, and to examine the relationships between stillbirth interventions and maternal grief, and demographic data. Testing was conducted using descriptive and correlation analyses, and multiple regression analyses. RESULTS: In this study women were suffering high levels of grief. Using stepwise regression analyses, eight predictors explained 15.4% of the variance in maternal grief and were significant predictors of grief, including three demographic variables (living children, non-white race, pregnancy history), and five stillbirth interventions, (option for autopsy, option for hospital disposal, opportunity to talk, clear communication, and memory box). Women who had lower grief scores reported having living children, were non-white, reported having had the option for hospital disposal of the baby’s body, having had the opportunity to talk, reported clear communication while in the hospital, and reported receiving a memory box. Women who had higher grief scores had had more pregnancies and included those women who had had the option for an autopsy. CONCLUSIONS: Women in this study were experiencing high levels of grief, even two years after their stillbirth. The findings of this study provide insight into the effects of stillbirth interventions on maternal grief. Change is mandated in the care of women who experience a stillbirth. Change would be best facilitated by going beyond the checklists at the bedside to address the need for effective interventions for the grief experienced by women after a stillbirth. Developing bedside practices to address these findings can assist women and families in their grieving and perhaps lead to positive growth.

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