The Silent Child—Mothers' Experiences Before, During, and after Stillbirth

Trulsson, Otti RN, RM
Rådestad, Ingela RN, RM, PhD

Otti Trulsson is midwife in the Department of Women's Health, Ullevåls University Hospital, Oslo, Norway; and Ingela Rådestad is Associate Professor in the Department of Caring and Public Health Science, Mälardalens University, Västerås, Sweden.

Address correspondence to Ingela Rådestad, Department of Caring and Public Health Science, Mälardalens University, Box 883, 721 23 Västerås, Sweden.

Funding for this study was provided by the research fund from the Association for Infant Death Society in Varberg, Sweden.

Birth: Issues in Perinatal Care 31(3):p 189-195, September 2004.

Background

The quality of care received by a woman who gives birth to a dead baby is crucial for her long-term well-being, and limiting the period between diagnosis of intrauterine death and induction of delivery decreases her anxiety risk. The primary objective of this study was to explore why induction of delivery for most women should not be delayed more than 24 hours from the diagnosis of intrauterine death. A secondary objective was to determine how the time between diagnosis and delivery should be spent.

Methods

Twelve women were interviewed about their experience before and during the diagnosis of their baby's death and the event of birth. Interviews took place 6 to 18 months after the delivery and were analyzed using a phenomenological methodology.

Results

Women experienced premonition, difficulty communicating their worry, cessation of verbal communication with staff, unreality and numbing, desire to get rid of the dead child immediately, going through childbirth, and total silence. Many women believed that they were not respected as a human being during the process of diagnosing the intrauterine death. Themes emerged indicating caregivers should not reduce to zero the time between diagnosis of intrauterine death and induction of delivery. Time may be needed to obtain medical information about the delivery and to prepare the woman for meeting with and saying goodbye to her long-awaited but now silent baby.

Conclusion

The period between diagnosis of intrauterine death and induction of delivery may give health professionals a major opportunity to improve a woman's ability to cope with the event of stillbirth and prepare her to meet with her loved but now silent baby. Further clinical research can identify supportive mechanisms for parents, and sources of iatrogenic psychological trauma that should be eliminated.