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Review
. 2023 Jun 27;2(1):e000262.
doi: 10.1136/bmjmed-2022-000262. eCollection 2023.

Stillbirth: prevention and supportive bereavement care

Bethany Atkins  1   2 , Lindsay Kindinger  3   4 , Muhammad Pradhiki Mahindra  1 , Zoe Moatti  5 , Dimitrios Siassakos  1
Affiliations
Review

Stillbirth: prevention and supportive bereavement care

Bethany Atkins et al. BMJ Med. .

Abstract

Around half of the two million stillbirths occurring worldwide each year are preventable. This review compiles the most up-to-date evidence to inform stillbirth prevention. Many general maternal health interventions also reduce the risk of stillbirth, for example, antenatal care attendance. This review focuses on specific aspects of care: glucose metabolism, targeted aspirin prophylaxis, clotting and immune disorders, sleep positions, fetal movement monitoring, and preconception and interconception health. In the past few years, covid-19 infection during pregnancy has emerged as a risk factor for stillbirth, particularly among women who were not vaccinated. Alongside prevention, efforts to address stillbirth must include provision of high quality, supportive, and compassionate bereavement care to improve parents' wellbeing. A growing body of evidence suggests beneficial effects for parents who received supportive care and were offered choices such as mode of birth and the option to see and hold their baby. Staff need support to be able to care for parents effectively, yet, studies consistently highlight the scarcity of specific bereavement care training for healthcare providers. Action is urgently needed and is possible. Action must be taken with the evidence available now, in healthcare settings with high or low resources, to reduce stillbirths and improve training and care.

Keywords: Epidemiology; Obstetrics; Pregnancy complications; Prenatal care.

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Conflict of interest statement

Competing interests: We have read and understood the BMJ policy on declaration of interests and declare the following interests: BA was secretary and DS co-chair of the Bereavement Working Group of the International Stillbirth Alliance during the writing of this review. BA, DS, and ZM are co-leads on the SUPPORT bereavement care course, which is discussed in the review.

Figures

Figure 1
Figure 1
Factors increasing the risk of stillbirth. PCOS=polycystic ovary syndrome
See this image and copyright information in PMC

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