Pregnancy after stillbirth: an international qualitative analysis of the patient experience – research In progress

Pregnancy after stillbirth: an international qualitative analysis of the patient experience – research In progress

Sarah Gower (1,3), Aleena M Wojcieszek (2), Vicky Flenady (2), Claire Kendall (3), Andrew Papadopoulos (1)

(1) Population Medicine (Epidemiology) University of Guelph, Canada, (2) Mater Research Institute, University of Queensland, Australia, (3) Department of Family Medicine, University of Ottawa, Canada

Introduction:
In Canada, about 3000 stillbirths occur per year, 3.5-5 per 1000 live births. Many of these families will conceive again shortly after this devastating loss, but these subsequent pregnancies are fraught with anxiety and worry for multiple reasons. There are few guidelines on how to best care for these patients, medically or psychologically. Prenatal care studies frequently leave out women who have had stillbirths. They are either excluded during recruitment, considered “confounding” during analysis, or it is simply not specified if women’s previous births were live or not. This is the gap we’re interested in.

Descriptions of Methods:
This study is a retrospective analysis of a cross-sectional survey. The data is secondary data from a large-scale multi-language, web-based survey of 2716 bereaved parents across 40 countries in six languages, as part of The Lancet Stillbirth Series Call to Action: Impact on Priorities in High-Income Countries . A subsection of this survey was answered by respondents who reported a subsequent pregnancy after their stillborn baby. In addition to quantitative questions, three open-ended questions were asked about perceptions of their care in that subsequent pregnancy and how that care could have been improved. A social constructivist framework will look to those written responses of patients to gain access to their experiences. Our epistemological assumption is that the reality of the patient experience is subjective, meaning it is constructed from the patients themselves, rather than verifying ideas we already hold. Inductive thematic analysis with an open coding framework and constant comparative method will give a robust insight into parents’ experiences and what would be considered high quality, excellent care.

Summary:
What are the most important aspects of patient-centred care in pregnancy after stillbirth, from the parent perspective? This is research in progress and results are expected by Spring 2020.

Ethics statement:
This is a secondary data analysis -data is currently housed at the Mater Research Institute, University of Queensland. Original study received approval through the Mater Institute as: Project 22696: “Priorities to address stillbirth in high income countries”.We have received amendment approval to share the data with the primary authour: Amendment to Project 22696. Reference: AM/MML/22696 (V2). -now applying for ethics approval through the University of Guelph, Ontario, Canada, for use of secondary data. -then data sharing agreement will be put in place between our institutions.


International Stillbirth Alliance, Annual Conference on Perinatal Mortality and Bereavement Care, Madrid, Spain. October 5-6th, 2019.

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