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Published on: January 12, 2018
Conversations About Stillbirth Risk in Routine Antenatal Care: A Qualitative Study Post-Implementation of the Safer
Christine Andrews1, Ashley Pade1, Fran Boyle1,2
1Centre of Research Excellence in Stillbirth, Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia.
Objective:
This study explores women's and healthcare professionals' experiences and attitudes towards stillbirth risk and prevention conversations following Safer Baby Bundle (SBB) implementation. The SBB aimed to normalise these conversations within the antenatal healthcare setting.
Design:
A qualitative interview study.
Setting:
Maternity services in two states in Australia.
Population Of Sample:
Eighteen postnatal women and 22 healthcare professionals at services that participated in the SBB.
Methods:
Qualitative study using semi-structured interviews analysed using a deductive approach to thematic analysis.
Main Outcome Measures:
Themes identified around experiences of and attitudes towards antenatal care and conversations related to stillbirth risk and prevention.
Results:
Three key themes related to conversations about stillbirth in antenatal care were identified. First, 'the importance of information that reassures and empowers' through respectful communication, emphasising the 'why' of preventive actions, prioritising conversations over written information and positive framing. Second, 'normalising sensitive conversations' by reducing silence and stigma around stillbirth, having a standard way of doing things and shifting perceptions about the difficulty of raising this topic during pregnancy. Third, 'steps towards respectful and supportive woman-centred care' influence the efficacy and responsiveness of conversations through continuity of care and carer for trust-building and an ethos of addressing what matters most to women.
Conclusions:
Integrating conversations about stillbirth into routine antenatal care is facilitated by the SBB. Key considerations for effective, woman-centred conversations about stillbirth include multidisciplinary collaboration, targeted HCP training and co-designed resources to promote open communication, reducing fragmentation of care and a strengths-based approach to discussing risk.
Trial Registration:
Australian New Zealand Clinical Trials Registry database: ACTRN12619001777189 (16 December 2019).
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