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Counseling parents after fetal demise and stillbirth

INTRODUCTION

Fetal death/stillbirth is one of the most stressful life events. Almost one-half of late fetal deaths occur in apparently uncomplicated pregnancies, usually before labor begins; thus, most parents are unprepared when told that the fetus has died. The family's anticipation of a joyous birth is supplanted by despair, confusion, and loss, including loss of a desired child, loss of self-esteem in the role of parent, and loss of confidence in the ability to produce a healthy child [1]. Observational studies describe psychological sequelae in parents, such as depression, posttraumatic stress disorder, and anxiety, as well as deleterious effects in the subsequent pregnancy [2].

Clinicians should be knowledgeable about these issues when they approach parents during the stressful situation of a fetal demise/stillbirth, and they should be able to provide patient-centered, compassionate, psychosocial care [3-5]. Supporting parents and creating a trusting relationship with them can affect how they respond to bereavement [6-8]. However, the best approach is unclear as the effectiveness of various forms of intervention on parents and families who have experienced fetal death/stillbirth has not been evaluated rigorously, particularly in comparative trials [9].

This topic will review the psychosocial care and counseling of couples who have had a stillbirth. Other issues related to stillbirth can be found separately:

(See "Incidence, etiology, and prevention of stillbirth".)

(See "Diagnosis and management of stillbirth".)

               

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Literature review current through: Jul 2014. | This topic last updated: Jul 11, 2014.
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