Factors Contributing to Uptake of Stillbirth Evaluations: A Qualitative Analysis

Abstract

Objective

The purpose of this study was to explore individuals' beliefs, values, and experiences surrounding stillbirth evaluation decisions.

Design

Qualitative research.

Setting

University of Utah Health.

Population

Parents who experienced a stillbirth in the past 5 years (n = 19) were interviewed about their experiences and decision to consent to or decline stillbirth evaluations, such as autopsy, placental histopathology, or genetic testing.

Methods

Qualitative content analysis.

Main Outcome Measures

Barriers and facilitators to parentsstillbirth postmortem decision-making.

Results

Participants communicated several facilitators and barriers that contributed to their stillbirth evaluation decision. Reasons for consenting to evaluations were belief in science, background in medicine, altruism, to inform future pregnancies, thinking about preventing another stillbirth, and how patients viewed the care of their stillborn by the medical team. Reasons for declining evaluations were receiving a diagnosis prior to being offered a postmortem evaluation, intent to avoid causing further harm to the baby, interest to spend more time with their baby, and cost of the evaluation.

Conclusion

Stillbirth is one of the most difficult experiences of a parent. Diagnostic and emotional barriers create further challenges to decision-making for stillbirth postmortem evaluations. Parents often rely on inadequate information and personal values and beliefs during this time-sensitive decision process. Decision support for stillbirth evaluations and training for medical providers could benefit parents, may increase stillbirth evaluation uptake, and potentially prevent decisional regret.

Funding

Research reported in this publication was supported by the Utah Centre for Excellence in ELSI Research (UCEER).