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Care associated with stillbirth for the most disadvantaged women

A study by Maggie Redshaw and Jane Henderson shows that women living in the most deprived areas in England, who are most at risk of stillbirth, perceived their care more negatively than other women.

In this study, women who had suffered a stillbirth were asked nine months later about their care around the time of the stillbirth. Women resident in the most deprived areas were significantly less likely to feel spoken to so that they could understand and treated with respect. Free text comments indicated that these women had difficulty accessing care, that communication was poor, many of them did not feel cared for, and felt that more could have been done to save their baby.

The study is published in the Birth journal and you can read it here.

Partners' mental health and well-being may be affected by holding their baby after stillbirth

A study by Julie Hennegan, Jane Henderson and Maggie Redshaw shows increased risk of depression and post-traumatic stress disorder (PTSD)-type symptoms in fathers who held their stillborn babies.

In this study, women were asked at nine months whether their partner had seen and held their stillborn baby after birth, and about their partners' subsequent wellbeing. Almost all fathers, 92%, saw their baby, and 82% held them.

At three months, partners who had held their stillborn babies had more than two-and-a-half times the risk of depression, and nearly twice the risk of PTSD-type symptoms compared to those who had not held their stillborn babies, even when comparing partners of similar characteristics. There was weaker evidence at nine months of a difference in outcomes between fathers who had held their stillborn baby and ones that had not, although a trend towards poorer outcomes remained.

You can read the study in the Journal of Reproductive and Infant Psychology.

What information do women need when choosing where to give birth?

Current guidelines support offering ‘low risk’ women a choice of birth setting, including a midwifery unit, at home, or in a hospital labour ward or obstetric unit.  But how do women choose between these options and what information do they receive and need in order to make a choice?

As part of the Birthplace Choices project, a team of researchers led from the NPEU by Jennifer Hollowell and  Rachel Rowe, and also including Lisa Hinton from the Nuffield Department of Primary Care Health Sciences, carried out a focus group study using an innovative online approach with a national sample of pregnant women to explore their choices.

Women in our study drew on multiple sources of information when choosing where to give birth; their midwife was not their primary source of information.  Women wanted to be able to know what their options were early in pregnancy and to be able to consider, explore and discuss these with their midwife throughout their pregnancy, not at a fixed point in time. 

You can read the paper which is published in BMC Pregnancy and Childbirth.

Care and self-reported outcomes of care experienced by women with mental health problems in pregnancy

Mental health problems in pregnancy and the postnatal period are relatively common and are associated with an increase in adverse outcomes. Jane Henderson, Julie Jomeen and Maggie Redshaw have conducted a study, using data from an English survey, to describe the care received by women with mental health problems in pregnancy, and to describe the effects of support, advice and treatment on outcomes in the postnatal period.

They found that women with antenatal mental health problems were significantly more worried at the prospect of labour and birth, had lower satisfaction with the experience of birth, worse postnatal mental health, and indications of poorer attachment to their baby. They also found that these women received substantially more care than other women but they did not always view this positively. 

These results suggest that health care professionals may need additional training to effectively support women with mental health problems during the perinatal period.

You can read more about the study which has been published in Midwifery journal.

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