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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 or decline postmortem
evaluations Methods. Qualitative content analysis Main
outcome measures. Barriers and facilitators to parents’stillbirth
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. Participants identified stillbirth as
one of their most difficult experiences as 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.