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The unheard parental cry of a stillbirth: fathers and mothers

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

A Correspondence to this article was published on 22 December 2021

A Correspondence to this article was published on 02 November 2021

Abstract

Purpose

Our objective was to compare the prevalence of depression, anxiety, stress, and domestic violence among parents after a stillbirth vs. livebirths and assessing of the need for psychological and pharmacological interventions for the affected individuals.

Methods

This was a prospective cohort study conducted in a tertiary care public sector hospital Northern India. 150 consecutive couples with a recent stillbirth (group 1) and 150 couples with a recent live birth (group 2) were enrolled. They were screened for depression (EPDS scale), anxiety (GAD-7), stress (PSS). Apriori sample size was calculated. Screen positive mothers and fathers were compared for the presence of depression, anxiety and stress, domestic violence, and need for treatment interventions.

Results

Depression was higher in group 1 mothers (39.3 vs 14.0%, p < 0.001) as well as fathers (18.1 vs 6.7%, p value = 0.022). Anxiety and moderate to severe stress were also significantly higher in stillborn than liveborn groups respectively. Characteristics associated with higher risk are analyzed. Domestic violence was found in 6.7% in group 1 and 2.7% in group 2 mothers (p value 0.169). Pharmacotherapy and counselling were required by 11.3 and 18.0% in stillbirth versus 3.3 and 18.7% in livebirth group, respectively.

Conclusion

Couples suffering stillbirths are at higher risk of depression, anxiety, and stress. We highlight this obstetrical public health issue, especially for the low middle income countries (LMIC) and advocate development of health policies for mental health screening of couples suffering stillbirths.

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References

  1. Staneva A, Boggosian F, Pritchard M, Wittkowski A (2015) The effects of maternal depression, anxiety and perceived stress during pregnancy on preterm birth: a systematic review. Women Birth 28(3):179–193

    Article  Google Scholar 

  2. Lewkowitz AK, Rosenbloom JI, Keller M, Macones GA, Olsen MA, Cahill AG et al (2019) Association between stillbirth at or after 23 weeks gestation and acute psychiatric illness within 1 year of delivery. Am J Obstet Gynecol 221(5):491.e1-491.e22

    Article  Google Scholar 

  3. Obst KL, Due C, Oxlad M, Middleton P (2020) Men’s grief following pregnancy loss and neonatal loss: a systematic review and emerging theoretical model. BMC Pregnancy Childbirth 20(1):11

    Article  Google Scholar 

  4. Heazell AEP, Siassakos D, Blencowe H, Burden C, Bhutta ZA, Cacciatore J et al (2016) Stillbirths: economic and psychosocial consequences. Lancet 387(10018):604–616

    Article  Google Scholar 

  5. Ing H, Fellmeth G, White J, Stein A, Simpson JA, McGready R (2017) Validation of Edinburgh postnatal depression scale (EPDS) on the Thai-Myanmar border. Trop Doct 47(4):339–347

    Article  Google Scholar 

  6. Rutter LA, Brown TA (2017) Psychometric properties of the generalized anxiety disorder scale-7 (GAD-7) in outpatients with anxiety and mood disorders. J Psychopathol Behav Assess 39(1):140–146

    Article  Google Scholar 

  7. Eun-Hyun Lee RN (2012) Review of the psychometric evidence of the perceived stress scale. Asian Nurs Res 7(2):159–160

    Google Scholar 

  8. Indu PV, Remadevi S, Vidhukumar K, Anilkumar TV, Subha N (2011) Development and validation of domestic violence questionnaire in married women aged 18–55 years. Indian J Psychiatry 53(3):218–223

    Article  CAS  Google Scholar 

  9. Brockington IF, Fraser C, Wilson D (2006) The postpartum bonding questionnaire: a validation. Arch Womens Ment Health 9:233–242

    Article  CAS  Google Scholar 

  10. Boyle FM, Vance JC, Najman JM, Thearle MJ (1996) The mental health impact of stillbirth, neonatal death or SIDS: prevalence and patterns of distress among mothers. Soc Sci Med 43(8):1273–1282

    Article  CAS  Google Scholar 

  11. Aminu M, Broek N (2019) Stillbirth in low and middle-income countries: addressing the ‘silent epidemic.’ Int Health 11(4):237–239

    Article  Google Scholar 

  12. Human M, Green S, Groenewald C, Goldstein RD, Kinney HC, Odendaal HJ (2014) Psychological implications of stillbirth for the mother and her family: a crisis-support approach. Soc Work 50(4):392

    Article  Google Scholar 

  13. Husain N, Parveen A, Husain M (2011) Prevalence and psychosocial correlates of perinatal depression: a cohort study from urban Pakistan. Arch WomensMent Health 14(5):395–403

    Article  Google Scholar 

  14. Badenhorst W, Riches S, Turton P, Hughes P (2006) The psychological effects of stillbirth and neonatal death on fathers: systematic review. J Psychosom Obstet Gynaecol 27(4):245–256

    Article  Google Scholar 

  15. Due C, Chiarolli S, Riggs DW (2017) The impact of pregnancy loss on men’s health and wellbeing: a systematic review. BMC Pregnancy Childbirth 17(1):380

    Article  Google Scholar 

  16. Jones K, Robb M, Murphy S, Davies A (2019) New understandings of fathers’ experiences of grief and loss following stillbirth and neonatal death: a scoping review. Midwifery. https://doi.org/10.1016/j.midw.2019.102531

    Article  PubMed  PubMed Central  Google Scholar 

  17. Cacciatore J, Erlandsson K, Rådestad I (2013) Fatherhood and suffering: a qualitative exploration of Swedish men’s experiences of care after the death of a baby. Int J Nurs Stud 50(5):664–670

    Article  CAS  Google Scholar 

  18. Boyle FM, Najman JM, Vance JC, Thearle MJ (1996) Estimating nonparticipation bias in a longitudinal study of bereavement. Aust N Z J Pub Health 20(5):483–487

    Article  CAS  Google Scholar 

  19. Hogue CJR, Parker CB, Willinger M, Temple JR, Bann CM, Silver RM et al (2015) The association of Stillbirth with Depressive symptoms 6–36 months post-delivery. Paediatr Perinat Epidemiol 29(2):131–143

    Article  Google Scholar 

  20. Gold KJ, Leon I, Boggs ME, Sen A (2016) Depression and posttraumatic stress symptoms after perinatal loss in a population-based sample. J Women’s Health 25(3):263–269

    Article  Google Scholar 

  21. Skari H, Skreden M, Malt UF, Dalholt M, Ostensen AB, Egeland T et al (2002) Comparative levels of psychological distress, stress symptoms, depression and anxiety after childbirth—a prospective population-based study of mothers and fathers. BJOG 109(10):1154–1163

    PubMed  Google Scholar 

  22. Flenady V, Boyle F, Koopmans L, Wilson T, Stones W, Cacciatore J (2014) Meeting the needs of parents after a stillbirth or neonatal death. BJOG 121(4):137–140

    Article  Google Scholar 

  23. Lavender T, Walkinshaw SA (1998) Can midwives reduce postpartum psychological morbidity? A randomized trial. Birth 25(4):215–219

    Article  CAS  Google Scholar 

  24. Gamble J, Creedy D, Moyle W, Webster J, McAllister M, Dickson P (2005) Effectiveness of a counseling intervention after a traumatic childbirth A randomized controlled trial. Birth 32(1):11–19

    Article  Google Scholar 

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Acknowledgements

Ms Kusum Chopra for statistical analysis.

Author information

Author notes

  1. Avir Sarkar and Sujata Siwatch are joint co-first authors.

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    Avir Sarkar, Sujata Siwatch, Neelam Aggarwal & Rimpi Singla

  2. Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    Sandeep Grover

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  1. Avir Sarkar
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  2. Sujata Siwatch
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  3. Neelam Aggarwal
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  4. Rimpi Singla
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  5. Sandeep Grover
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Contributions

AS, SS, SG contributed to literature search, study design, data collection, analysis and writing. NS, RS contributed to study design, data interpretation, writing and revision of the draft.

Corresponding author

Correspondence to Sujata Siwatch.

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Conflicts of interest

The authors have no conflicts of interest relevant to this article.

Ethical approval

Institutional ethics committee, PGIMER, Chandigarh. Ref no. NK/5101/MD/785 in the letter dated 16/03/2019.

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Consent for participation and publication have been duly taken.

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Sarkar, A., Siwatch, S., Aggarwal, N. et al. The unheard parental cry of a stillbirth: fathers and mothers. Arch Gynecol Obstet 305, 313–322 (2022). https://doi.org/10.1007/s00404-021-06120-9

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  • DOI: https://doi.org/10.1007/s00404-021-06120-9

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