Background Stillbirth remains amongst the most challenging areas in obstetric practice. In Ireland, consultant obstetricians are ultimately responsible for care provided to mothers following stillbirth. This study explores the impact of stillbirth on consultants working in an Irish tertiary maternity hospital (9,000 births per annum) where the stillbirth rate is 4.6/1000.
Methods Semi-structured qualitative interviews lasting 30-60 minutes were conducted in 2012 with a 50% sample of consultant obstetricians and gynaecologists (n = 8). The study explored how consultants care for parents following stillbirth and the impact of stillbirth on them personally and professionally. The data were analysed using Interpretative Phenomenological Analysis.
Results The human response and the weight of responsibility were the dominant personal and professional themes identified. The human response to stillbirth highlighted the personal impact stillbirth has on consultants and how in turn it shapes the care they provide. Stillbirth was deemed one of the most difficult experiences; described as amongst ‘the most devastating news’ with the exception of two who felt stillbirth was not the worst outcome. Most consultants stressed the importance of their ‘human response’ to parents following a stillbirth. All stated that bereaved parents should receive direct care from a consultant. The weight of professional responsibility revealed the sense of burden that consultants feel when a baby dies. The possibility of a medico-legal challenge was a significant factor; mostly for those who are primarily gynaecologists, resulting in the question “what have I missed?”. Consultants also felt that ‘expectations are high that outcomes are going to be good’ which adds to the weight of professional responsibility
Conclusion Despite the impact and importance of stillbirth care, none of the obstetricians received any formal training in perinatal bereavement care yet all are required to care for families following the death of a baby. This study highlights a gap in training and the considerable impact of stillbirth on obstetricians professionally and personally. Medico-legal concerns following stillbirth potentially impact on the depth of care and warrants further research.
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