The association between seeing the stillborn baby and risk of postpartum depression and anxiety in Chinese women undergoing pregnancy termination: a prospective cohort study.

BACKGROUND

The practice of allowing women to see their stillborn baby after pregnancy termination is clinically debated, yet little is known about its psychological implications in Chinese cultural settings. This study aimed to assess the association between visual contact with a stillborn baby and the risk of postpartum depression (PPD) and anxiety (PPA) among Chinese women.

METHODS

This prospective cohort study recruited 202 women who underwent pregnancy termination due to stillbirth or a fetal anomaly between March 2022 and September 2023. Symptoms of depression and anxiety were assessed at baseline, and at 1 and 3 months following the termination using the Edinburgh Postnatal Depression Scale and the Generalized Anxiety Disorder Scale. Multivariable logistic regression was conducted to examine the association between seeing the stillborn baby and the risk of PPD and PPA, adjusting for potential confounders.

RESULTS

There was no significant impact of seeing the stillborn baby on the PPD and PPA at 1 month after termination. At 3 months after termination, seeing the stillborn baby was emerged as a significant protective factor against PPD (OR 0.28, 95% CI 0.13-0.59) and PPA (OR 0.12, 95% CI 0.05-0.27). These associations remained significant after adjusting for confounders, with an adjusted OR of 0.18 (95% CI: 0.08-0.42) for PPD and 0.12 (95% CI: 0.05-0.29) for PPA.

CONCLUSIONS

Visual contact with the stillborn baby may act as a protective factor against PPD and PPA. These findings underscore the importance of healthcare professionals providing respectful and sensitive care that is tailored to women's individual preferences during visual contact with the stillborn baby, with implications for improving clinical practice and guiding future research.