Stage-based bereavement support for parents after stillbirth: an umbrella review

Stillbirth is a profound and often under-recognised form of perinatal loss that can result in enduring grief. Despite numerous interventions, there is limited synthesis of evidence across the grief trajectory.

This umbrella review synthesised evidence from systematic reviews to identify bereavement support strategies for parents after stillbirth, structured by stages of grief.

Six databases and grey literature were searched for qualitative, quantitative, or mixed-methods systematic reviews. Two reviewers independently conducted screening, critical appraisal (JBI tools), and data extraction. A thematic synthesis and corrected covered area matrix addressed overlapping data.

Eleven reviews met the inclusion criteria. Strategies were mapped to three stages: (1) acute grief - empathetic presence, validation of loss, and immediate containment; (2) adjustment - relational support, memory-making, and peer-based programmes; and (3) long-term integration - structured follow-up, meaning-making, and anticipatory guidance for future pregnancies. Approaches differed in scope, intensity, and cultural framing.

This review proposes a stage-based framework to inform interdisciplinary, grief-informed bereavement care. Synthesised strategies may enhance the emotional recovery and long-term adaptation of bereaved parents following stillbirth.

PROSPERO: CRD420251035521 (registered 18 April 2025).