Women and birth : journal of the Australian College of Midwives · 2026
"The hardest 9 months of my life": Parents' experiences of care in pregnancies after perinatal loss in Australia.
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Loughnan Siobhan A, Ali Kathina, Wojcieszek Aleena M, Diget Ida Stevia, Singline Laura, Lancaster Ann, Porter Emma, Andrews Christine, Gordon Adrienne, Heazell Alexander E P, Leisher Susannah Hopkins, Cooper Amy, McCarthy Elizabeth, Postle Vanessa, Sneddon Anne, Vernon Barbara, Seeho Sean, Kumar Sailesh, Boyle Frances M, Flenady Vicki, Ellwood David
Аннотация
PROBLEM: Pregnancy after perinatal loss is associated with increased risks of adverse psychosocial and biomedical outcomes.
BACKGROUND: Standard antenatal care often fails to meet these parents' needs.
AIM: To explore parents' experiences of pregnancy after perinatal loss in Australia and understand the care and support they find most meaningful.
METHODS: National cross-sectional web-based survey of parents in Australia who had experienced perinatal loss and were pregnant or had completed a subsequent pregnancy in the preceding five years. Quantitative data were analysed largely descriptively; qualitative data underwent thematic analysis.
FINDINGS: Of 332 participants (97 % mothers), most experienced adverse mental health issues at least sometimes during the subsequent pregnancy (70-98 %). Most received additional or specialised care plans (74 %) and reported elements of respectful and compassionate care most-, or all of the time (73-91 %). Participants typically rated their care favourably. Most had access to medical components of care, such as an obstetrician (89 %) and additional ultrasound scans (87 %), while few reported the involvement of a specialist midwife (17 %), bereavement counsellor (23 %) or specialist antenatal classes for pregnancy after loss (5 %). Thematic analysis identified one overarching theme: recognition of the subsequent pregnancy and previous loss; and four subthemes: trusted healthcare professional in a continuity of carer model, additional care and monitoring, emotional and mental health support, and respectful communication.
DISCUSSION: Recognition of the subsequent pregnancy in the context of prior loss is essential.
CONCLUSION: Improving access to integrated, trauma-informed continuity of care models may better support parents in pregnancies after loss.
BACKGROUND: Standard antenatal care often fails to meet these parents' needs.
AIM: To explore parents' experiences of pregnancy after perinatal loss in Australia and understand the care and support they find most meaningful.
METHODS: National cross-sectional web-based survey of parents in Australia who had experienced perinatal loss and were pregnant or had completed a subsequent pregnancy in the preceding five years. Quantitative data were analysed largely descriptively; qualitative data underwent thematic analysis.
FINDINGS: Of 332 participants (97 % mothers), most experienced adverse mental health issues at least sometimes during the subsequent pregnancy (70-98 %). Most received additional or specialised care plans (74 %) and reported elements of respectful and compassionate care most-, or all of the time (73-91 %). Participants typically rated their care favourably. Most had access to medical components of care, such as an obstetrician (89 %) and additional ultrasound scans (87 %), while few reported the involvement of a specialist midwife (17 %), bereavement counsellor (23 %) or specialist antenatal classes for pregnancy after loss (5 %). Thematic analysis identified one overarching theme: recognition of the subsequent pregnancy and previous loss; and four subthemes: trusted healthcare professional in a continuity of carer model, additional care and monitoring, emotional and mental health support, and respectful communication.
DISCUSSION: Recognition of the subsequent pregnancy in the context of prior loss is essential.
CONCLUSION: Improving access to integrated, trauma-informed continuity of care models may better support parents in pregnancies after loss.