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Parental Perceptions of Counseling Regarding Interpregnancy Interval after Stillbirth or Neonatal Death
Karen J Gibbins1,2, Cara C Heuser2,3
1Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon.
American Journal of Perinatology
|March 14, 2023
Summary
Bereaved parents often receive varied interpregnancy interval (IPI) counseling after stillbirth or neonatal death. Many pursue shorter IPIs than recommended, with cesarean birth influencing recommendations.
Area of Science:
- Reproductive Health
- Perinatal Loss
- Maternal-Fetal Medicine
Background:
- Optimal interpregnancy intervals (IPIs) are established after live birth, but guidance for IPIs after stillbirth or neonatal death is lacking.
- Bereaved parents' experiences with IPI counseling and subsequent pregnancy intervals are not well understood.
Purpose of the Study:
- To describe the interpregnancy interval (IPI) counseling received by bereaved parents after pregnancy loss.
- To understand parents' reactions to IPI counseling and their subsequent actual IPIs.
Main Methods:
- A web-based survey was administered to bereaved parents who experienced stillbirth or neonatal death.
- Data collected included demographics, loss details, IPI counseling, and subsequent pregnancy intervals.
- Descriptive statistics and inferential tests (Wilcoxon, Spearman) were used for analysis.
Main Results:
- 275 surveys were analyzed; mean gestational age at stillbirth was 33.1 weeks, with 29% delivered via cesarean.
- Median recommended IPI (rIPI) was 6 months, primarily for healing (74%); cesarean delivery was associated with longer rIPI (9 vs. 4.2 months, p<0.0001).
- Median actual IPI was 6 months (IQR: 4-10 months); 144 parents attempted conception within a median of 3.5 months.
Conclusions:
- Bereaved parents receive diverse counseling regarding recommended interpregnancy intervals (rIPIs).
- The majority of parents pursue actual IPIs shorter than current national and international recommendations.
- Cesarean birth is linked to longer recommended IPIs, but maternal age is not a significant factor.
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