Communication following a stillbirth or neonatal death: room for improvement

To assess the extent of knowledge which mothers had about a previous stillbirth or neonatal death, their satisfaction with the information and advice given them, and their degree of anxiety during a subsequent pregnancy.

Personal interview.

Antenatal clinic of a British military hospital in Germany.

Forty-eight caucasian, pregnant women, 28 of whom had had a previous stillbirth (Group A) and 20 a neonatal death (Group B).

Over half (25/48) the women had a poor or confused knowledge of the events surrounding the death, only 29% were satisfied with the information they had received, and nearly 40% became pregnant within six months of the death despite medical advice against conceiving soon after such an event. The mothers of stillborn babies were significantly less likely to know the birthweight than the mothers of babies who died after birth (60% vs 95%), and 40% had not given the baby a name. Over a third of the mothers were admitted to hospital because of anxiety about the current pregnancy.

Dissatisfaction with the quality of information given by hospital staff, rapid conception despite medical advice to the contrary, and anxiety in a subsequent pregnancy were common after a previous stillbirth or neonatal death. A poor or confused knowledge about the baby's death was more likely if the death had been intrauterine and unexplained, or associated with maceration, a lethal abnormality, an emergency delivery resulting in stillbirth, or a preventable cause.