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Is care of stillborn babies and their parents respectful? Results from an international online survey
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  • Bethany Atkins,
  • Hannah Blencowe,
  • Fran Boyle,
  • Emma Sacks,
  • Dell Horey,
  • Vicki Flenady
Bethany Atkins
University College London

Corresponding Author:[email protected]

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Hannah Blencowe
Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT
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Fran Boyle
University of Queensland
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Emma Sacks
John Hopkins School of Public Health
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Dell Horey
la Trobe University
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Vicki Flenady
Mater Research Institute, University of Queensland
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Objective To quantify parents’ experiences of respectful care around stillbirth globally. Design Multi-country, online, cross-sectional survey. Setting and Population Self-identified bereaved parents (n=3769) of stillborn babies from 44 high- and middle-income countries. Methods Parents’ perspectives of 7 aspects of care quality, factors associated with respectful care, and 7 bereavement care practices were compared across geographical regions using descriptive statistics. Respectful care was compared between country income groups using multivariable logistic regression. Main Outcome Measures Self-reported experience of care around the time of stillbirth Results A quarter (25.4%) of 3769 respondents reported disrespectful care after stillbirth and 23.5% reported disrespectful care of their baby. Gestation <30 weeks, and primiparity were associated with disrespect. Reported respectful care was lower in middle-income countries (MICs) than in high-income countries (HICs) (aOR=0.35, 95%CI (0.29-0.42), p <0.01). In many countries, aspects of care quality need improvement, such as ensuring families have enough time with providers. Participating respondents from Latin America and Southern Europe reported lower satisfaction across all aspects of care quality compared to Northern Europe. Unmet need for memory-making activities in MICs is high. Conclusions Despite improvements, many parents still experience disrespectful care around stillbirth. The gap between parents’ access to memory-making activities in MICs and HICs needs urgent attention. Tweetable abstract A quarter of parents of stillborn babies experience disrespectful care. There is global unmet need for memory-making activities
25 Oct 2021Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
26 Oct 2021Submission Checks Completed
26 Oct 2021Assigned to Editor
27 Oct 2021Reviewer(s) Assigned
17 Nov 2021Review(s) Completed, Editorial Evaluation Pending
22 Dec 2021Editorial Decision: Revise Major
26 Jan 20221st Revision Received
03 Feb 2022Submission Checks Completed
03 Feb 2022Assigned to Editor
03 Feb 2022Review(s) Completed, Editorial Evaluation Pending
07 Feb 2022Editorial Decision: Accept
Sep 2022Published in BJOG: An International Journal of Obstetrics & Gynaecology volume 129 issue 10 on pages 1731-1739. 10.1111/1471-0528.17138