Priority Area Three

Implementing best practice in care after stillbirth and in subsequent pregnancies

Priority Area Three leads: Associate Professor Fran Boyle, Professor Jonathan Morris, Ms Aleena Wojcieszek (ECR lead), Professor David Ellwood, Dr Dell Horey

Priority area three focuses on improving care around the time of stillbirth, and in subsequent pregnancies. The psychosocial impact on mothers and families and society is substantial, yet the care received by parents in Australia is highly variable. Our studies show parents’ needs are frequently unmet. Parents face many critical decisions following stillbirth and more support and guidance is needed, particularly around autopsy consent. For those embarking on subsequent pregnancies, there is a five-fold increased risk of stillbirth. Heightened anxiety and fear in subsequent pregnancies is common, yet there is little guidance for clinicians on the optimal clinical care for these women. The additional economic costs of stillbirth need to be quantified for efficient health service planning. Based on our strong clinical and research experience in this area including clinical practice recommendations, we will implement best practice on immediate care after a stillbirth and develop a model of best practice in a subsequent pregnancy.

  • Implementation of best practice care after stillbirth

    Leads: A/Prof Fran Boyle, Dr Dell Horey

    The psychosocial impact of stillbirth on mothers and families and society is substantial, yet the care received by parents in Australia is highly variable. This study aims to improve care for parents and families immediately following stillbirth. We will also explore effective strategies for how to support parents to make a decision about having an autopsy of their baby.

  • Care prior to and during subsequent pregnancies following stillbirth for improving outcomes - a Cochrane systematic review

    Lead: Ms Aleena Wojcieszek

    Parents entering a pregnancy after stillbirth face an increased risk of stillbirth, along with many other adverse outcomes. These parents often experience intense anxiety during subsequent pregnancies, which may also contribute to poor outcomes. Expectant parents who have previously had a stillborn baby are likely to benefit from extra medical care and emotional support, but there is currently little evidence to help clinicians provide the best care to these parents. The aim of this study is to assess the effects of different interventions or models of care prior to and during subsequent pregnancies following stillbirth on maternal, fetal, neonatal and family health outcomes, and health service utilisation.

    The protocol for this study has been published and is freely available here.

  • Care in subsequent pregnancies following stillbirth: an international survey of parents

    Lead: Ms Aleena Wojcieszek

    Parents entering a pregnancy after stillbirth face an increased risk of stillbirth, along with many other adverse outcomes. These parents often experience intense anxiety during subsequent pregnancies, which may also contribute to poor outcomes. There is little research on best practice care in pregnancies after stillbirth. In this study we asked parents from 40 countries about the care they received during pregnancies following stillbirth.

    This study has been published in BJOG: an international journal of obstetrics and gynaecology and is freely available here.

  • Future research directions for to inform clinical practice for care in pregnancies after stillbirth

    Lead: Ms Aleena Wojcieszek

    Providing high-quality care in subsequent pregnancies following stillbirth has been identified as a priority. However, there is little evidence to inform clinical practice during these pregnancies. By consulting with an international panel of experts in stillbirth research, this study aims to identify the specific research directions most pressing, appropriate, and valuable to informing clinical practice in this area.

  • A 30-year follow-up of parents whose baby was stillborn

    Leads: A/Prof Fran Boyle, Dr Dell Horey

  • Current practices, views, and experiences with bereavement care - a survey of hospitals

    Leads: A/Prof Fran Boyle, Dr Dell Horey

  • Developing decision-support tools for autopsy consent following stillbirth

    Leads: A/Prof Fran Boyle, Dr Dell Horey

  • Economic evaluation of care after stillbirth

    Lead: Dr Emily Callander

    PhD students: Ms Haly Fox

  • Parent guideline for best practice after a stillbirth

    Leads: A/Prof Fran Boyle, Dr Dell Horey

  • Understanding clinicians decision-making needs for autopsy consent after stillbirth: framework analysis of a large survey

    Leads: A/Prof Fran Boyle, Dr Dell Horey