A comparison of women's memories of care during pregnancy, labour and delivery after stillbirth or live birth.

OBJECTIVE

To compare women's reports of aspects of their care during pregnancy, labour and delivery following stillbirth and live birth.

DESIGN

Data were collected by postal questionnaire in 1994.

SETTING

A Swedish nation-wide population-based study of cohorts defined in 1991.

PARTICIPANTS

Three hundred and fourteen women with stillbirth (subjects) and 322 women with live birth (controls).

MEASUREMENTS AND FINDINGS: Labour and delivery were assessed as physically 'insufferably hard' by 52 (17%) of the subjects and 33 (10%) of the controls. The corresponding figures for emotional strains were 144 (47%) and 21 (7%). Obstetric analgesia was more frequently used during labour for stillbirth. One hundred and thirty-eight (44%) subjects, as compared to 44 (2%) of the controls, left hospital within 24 hours of birth. Almost all the women with stillbirth 296 (95%) stated that it was important to have an explanation of the baby's death. Adverse events related to bromocriptine given to inhibit postpartum lactation, were reported by 60 (22%) of the subjects.

KEY

CONCLUSIONS

It is possible to ease the distress of labour and delivery for stillbirth. Discussion of the aetiology of the baby's death with the mother should be a priority. The optimal length of stay in hospital after stillbirth remains to be defined. Non-pharmacological inhibition of lactation may be presented as an alternative to bromocriptine, breast binding is a concrete 'reality confrontation' for the woman and may aid her in her grieving process. Further studies concerning breast binding vs pharmacological inhibition of lactation and long-term psychological outcome are warranted.