Parents entering a subsequent 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 improve the quality of care for women and families receive across Australia in a pregnancy after stillbirth through an evidence-based approach to monitoring of maternal health, fetal surveillance, and psychosocial support. A pilot study assessing feasibility and acceptability of a proposed approach to care across CRE sites will be carried out, with subsequent large-scale rollout across Women’s Healthcare Australasia sites.
Priority Area Three leads: Associate Professor Fran Boyle, Professor Jonathan Morris, Ms Aleena Wojcieszek
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.
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.