Psychological complications after stillbirth--influence of memories and immediate management: population based study.

Abstract Objective : To identify factors that may predict long term psychological complications among women who have had a stillborn child. Design : Nationwide population based study using epidemiological methods. Subjects : 380 subjects and 379 controls who had had a stillborn or non-deformed live child in Sweden in 1991. Results : Information was provided by 636 (84%) women. The ratio (95% confidence interval) of proportions of women with symptoms related to anxiety above the 90th centile for women who had had a stillborn child compared with those who had not was 2.1(1.2 to 3.9). An interval of 25 hours or more from the diagnosis of death in utero to the start of delivery gave a ratio of 4.8 (1.5 to 15.9). The ratio was 2.3 (1.1 to 5.3) for not seeing the child as long as the mother had wished and 3.1 (1.6 to 6.0) for no possession of a token of remembrance. Conclusion : It is advisable to induce the delivery as soon as feasible after the diagnosis of death in utero. A calm environment for the woman to spend as much time as she wants with her stillborn child is beneficial, and tokens of remembrance should be collected. Key messages This study used an anonymous postal question- naire to 636 women to assess mothers9 needs It shows that it is advisable to induce the delivery as soon as feasible after the diagnosis of death in utero A calm environment, with the mother able to spend as much time as she wants with her dead newborn child, is beneficial, as are tokens of remembrance of the child Rather than enforcing mourning rituals, flexibil- ity should be shown towards the mother9s own needs