A difficult conversation? The views and experiences of parents and professionals on the consent process for perinatal postmortem after stillbirth

Heazell, A. E. P., McLaughlin, M-J, Schmidt, E. B., Cox, P., Flenady, V., Khong, T. Y. and Downe, S. (2012) A difficult conversation? The views and experiences of parents and professionals on the consent process for perinatal postmortem after stillbirth. Bjog-An International Journal of Obstetrics and Gynaecology, 119 8: 987-997.


Author Heazell, A. E. P.
McLaughlin, M-J
Schmidt, E. B.
Cox, P.
Flenady, V.
Khong, T. Y.
Downe, S.
Title A difficult conversation? The views and experiences of parents and professionals on the consent process for perinatal postmortem after stillbirth
Journal name Bjog-An International Journal of Obstetrics and Gynaecology  (ERA 2012 Listed)    (ERA 2010 Rank A)   Check publisher's open access policy
Publication date 2012-07
Sub-type Article
DOI 10.1111/j.1471-0528.2012.03357.x
Volume number 119
Issue number 8
ISSN 1470-0328
Start page 987
End page 997
Total pages 11
Place of publication Oxford, United Kingdom
Publisher Wiley-Blackwell
Collection year 2013
Language eng
Formatted abstract Objective: To describe the experiences, knowledge and views of both parents and professionals regarding the consent process for perinatal postmortem.

Design: Internet-based survey.

Setting: Obstetricians, midwives and perinatal pathologists currently working in the UK. Parents who have experienced a stillbirth in the UK in the previous 10 years.

Sample: Obstetricians, midwives and perinatal pathologists registered with their professional bodies. Parents who accessed the Sands website or online forum.

Methods: Online self-completion questionnaire with both fixed-choice and open-ended questions.

Results: Responses were analysed from 2256 midwives, 354 obstetricians, 21 perinatal pathologists and 460 parents. The most common reason for parents to request postmortem examination was to find a cause for their baby's death; the prevention of stillbirths in others also ranked highly. Perinatal pathologists possessed greatest knowledge of the procedure and efficacy of postmortem, but were unlikely to meet bereaved parents. The majority of professionals and parents ranked emotional distress and a lengthy wait for results as barriers to consent. The majority of staff ranked workload, negative publicity, religion and cultural issues as important barriers, whereas most parents did not. Almost twice as many parents who declined postmortem examination later regretted their decision compared with those who accepted the offer (34.4 versus 17.4%).

Conclusion: Emotional, practical and psychosocial issues can act as real or perceived barriers for staff and bereaved parents. Education is required for midwives and obstetricians, to increase their knowledge to ensure accurate counselling, with due regard for the highly individual responses of bereaved parents. The contribution of perinatal pathologists to staff education and parental decision-making would be invaluable.
Keyword Autopsy
Consent
Counselling
Perinatal death
Postmortem
Stillbirth
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online: 16 May 2012.

Document type: Journal Article
Sub-type: Article
Collections: Official 2013 Collection
School of Medicine Publications
 
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