Supporting parents through stillbirth : a qualitative study exploring the views of health professionals and health care staff in three hospitals in England

Objective: To investigate the views of a range of hospital based health professionals and health care staff in the management of stillbirth • Design: A qualitative pilot study informed by grounded theory • Setting: Three hospital trusts based in the North East of England • Population or Sample: 21 consultant obstetricians, 3 trainees (including 1 senior trainee), 29 midwives, 3 midwife sonographers and 4 chaplains. • Methods: Focus groups and semi-structured interviews • Main Outcome Measures: To clarify experiences and views of hospital based health professionals and health care staff. To highlight potential gaps in training needs for these staff groups. • Results: Two different approaches in stillbirth management could be detected in our study. One approach emphasised the existing evidence-base and patient directed choice whilst the other emphasised tradition and profession-directed care. These differences were particularly apparent in choices over mode of delivery, and the location of women as well as the time interval between diagnosis and delivery. • Conclusions: Disagreement exists among clinicians regarding best practice in managing two important decisions in stillbirth: mode of delivery and location of women and the time interval between diagnosis and delivery. High quality evidence is needed regarding the long term impact, including the psychological and emotional sequelae, of these two key decisions in stillbirth. Such high quality evidence will enable clinicians to provide women with fully informed and meaningful choices.