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Background: Stillbirth is a devastating event for families as well as hospital staff. Hospital practices around internal and external staff communication, debriefing, and training are unknown. Methods: We systematically sampled U.S. hospitals that provide obstetrical care. Staff knowledgeable of bereavement care on labor and delivery were invited to participate in an anonymous survey linked to hospital descriptors. We evaluated stillbirth communication, debriefing, and training for staff. Results: We received 289 usable surveys from 429 eligible staff (67% response). Most (94%) noted hospitals' marked rooms housing bereaved families, but only a third (37%) reported a marker on the paper or electronic medical record. Half of the hospitals had no standard debriefings post-loss, and 38% reported no perinatal loss training for labor and delivery nurses. Conclusions: Hospitals have significant variations and gaps in staff communication, support, and training, which are key aspects of respectful stillbirth care. [ABSTRACT FROM AUTHOR]

Objectives: The quality and scope of perinatal bereavement care in the United States has been evaluated by surveying bereaved parents, but little is known about how care varies across hospitals. We sought to survey clinicians about stillbirth bereavement care practices at U.S. hospitals and to evaluate care by hospital birth volume. Methods: Using American Hospital Association data, we employed stratified random sampling to select 300 hospitals from all centers with at least 100 annual deliveries. Within each state, we divided all hospitals into size quartiles and randomly selected from each until we reached the goal number per state. We then identified a staff member knowledgeable about typical bereavement care on labor and delivery at each hospital and sent an on-line survey about care. We linked survey data with hospital characteristics and used summary statistics, Chi squared, and Fisher's Exact test to compare care by hospital birth volume. Results: We reached an eligible respondent at 429/551 hospitals and 396 of the 429 (73%) agreed to participate. We received 289 usable surveys for an overall response rate of 67%. Only one third of hospitals (n = 96, 33%) reported staff protected time for perinatal bereavement care. Of 17 bereavement topics, just six were routinely offered by at least two-thirds of the hospitals. Financial limitations and staff shortages were the most commonly identified barriers to care and were most pronounced at small-volume hospitals. Conclusions for Practice: This study offers a snapshot in bereavement care and identified important gaps for both large and small hospitals. Significance: What is already known on this subject?: While there have been efforts to improve hospital bereavement care for families after stillbirth, no researchers have surveyed U.S. hospital practices to assess current bereavement practices or how these practices vary across hospitals. What this study adds?: This study systematically sampled hospitals in all U.S. states to assess stillbirth bereavement care including memory-making, parental education, and barriers to optimal care and analyzed differences by hospital birth volume. The study found significant gaps including limited bereavement education about normal grief, mental health, impact on relationships, return to work, and the father's experience. [ABSTRACT FROM AUTHOR]

Purpose: Mental health providers are well-positioned to engage in suicide prevention efforts, yet implementation depends on skill acquisition and providers often report feeling underprepared. This pilot study explored the acceptability, feasibility, and preliminary effectiveness of three suicide prevention-focused simulations with virtual clients. Method: Students (n = 22) were recruited from a Master of Social Work program, completed pre- and post-test surveys, and engaged with three simulated trainings: (1) suicide risk assessment, (2) safety planning, and (3) motivating a client to treatment. Results: Simulations were reported to be acceptable and feasible, with strong student desire and need for greater suicide prevention training. We observed significant improvements over time in clinical skills via simulated training scores and perceptions of clinical preparedness. Discussion: Preliminary findings indicate simulated training with virtual clients is promising and suggest the three suicide prevention simulations may be useful, scalable, and effective in social work training programs and beyond. [ABSTRACT FROM AUTHOR]

We tested use of an online support group for women of color who had experienced stillbirth or early infant loss. We recruited recently bereaved mothers and asked them to participate in an existing online community for pregnancy and infant loss hosted on a commercial platform. Participants were asked to go online at least three times weekly for 6 weeks to read posts. Using a mixed-methods approach, we assessed attitudes toward online support, mental health, and experiences pre- and postintervention using written surveys and a brief phone interview. We used summary statistics for quantitative data and a deductive coding approach for qualitative data. Twenty participants completed the study. We found nonsignificant improvements in all four mental health domains (depression, post-traumatic stress disorder, moderate-severe generalized anxiety, and perinatal grief). Women reported the group allowed them to help others and feel less alone. They also reported that at times, posts could increase the intensity of their loss emotions. This study demonstrated feasibility to recruit, retain, and track participation in an online support group for perinatally-bereaved mothers of color. Although the study was not powered for outcome, all mental health measures showed nonsignificant improvements, suggesting value in further investigating online social support for improving women's mental health after perinatal loss. Clinical Trial Registration: Registered on clinicaltrials.gov [NCT04600076], October 19, 2020. [ABSTRACT FROM AUTHOR]

Background: Stillbirth, the death of a baby before birth, is associated with significant psychological and social consequences that can be mitigated by respectful and supportive bereavement care. The absence of high‐level evidence to support the broad scope of perinatal bereavement practices means that offering a range of options identified as valued by parents has become an important indicator of care quality. This study aimed to describe bereavement care practices offered to parents across different high‐income and middle‐income countries. Methods: An online survey of parents of stillborn babies was conducted between December 2014 and February 2015. Frequencies of nine practices were compared between high‐income and middle‐income countries. Differences in proportions of reported practices and their associated odds ratios were calculated to compare high‐income and middle‐income countries. Results: Over three thousand parents (3041) with a self‐reported stillbirth in the preceding five years from 40 countries responded. Fifteen countries had atleast 40 responses. Significant differences in the prevalence of offering nine bereavement care practices were reported by women in high‐income countries (HICs) compared with women in middle‐income countries (MICs). All nine practices were reported to occur significantly more frequently by women in HICs, including opportunity to see and hold their baby (OR = 4.8, 95% CI 4.0‐5.9). The widespread occurrence of all nine practices was reported only for The Netherlands. Conclusions: Bereavement care after stillbirth varies between countries. Future research should look at why these differences occur, their impact on parents, and whether differences should be addressed, particularly how to support effective communication, decision‐making, and follow‐up care. [ABSTRACT FROM AUTHOR]

Background: About 1 in every 150 pregnancies end in stillbirth. Consequences include symptoms of post traumatic stress disorder (PTSD), depression, and anxiety. Yoga has been used to treat PTSD in other populations and may improve health outcomes for stillbirth mothers. The purpose of this study was to determine: (a) feasibility of a 12-week home-based, online yoga intervention with varying doses; (b) acceptability of a "stretch and tone" control group; and (c) preliminary efficacy of the intervention on reducing symptoms of PTSD, anxiety, depression, perinatal grief, self-compassion, emotional regulation, mindfulness, sleep quality, and subjective health. Methods: Participants (N = 90) were recruited nationally and randomized into one of three groups for yoga or exercise (low dose (LD), 60 min per week; moderate dose (MD), 150 min per week; and stretch-and-tone control group (STC)). Baseline and post-intervention surveys measured main outcomes (listed above). Frequency analyses were used to determine feasibility. Repeated measures ANCOVA were used to determine preliminary efficacy. Multiple regression analyses were used to determine a dose-response relationship between minutes of yoga and each outcome variable. Results: Over half of participants completed the intervention (n = 48/90). Benchmarks (≥70% reported > 75% satisfaction) were met in each group for satisfaction and enjoyment. Participants meeting benchmarks (completing > 90% of prescribed minutes 9/12 weeks) for LD and MD groups were 44% (n = 8/18) and 6% (n = 1/16), respectively. LD and MD groups averaged 44.0 and 77.3 min per week of yoga, respectively. The MD group reported that 150 prescribed minutes per week of yoga was too much. There were significant decreases in PTSD and depression, and improvements in self-rated health at post-intervention for both intervention groups. There was a significant difference in depression scores (p =.036) and grief intensity (p =.009) between the MD and STC groups. PTSD showed non-significant decreases of 43% and 56% at post-intervention in LD and MD groups, respectively (22% decrease in control). Conclusions: This was the first study to determine the feasibility and preliminary efficacy of an online yoga intervention for women after stillbirth. Future research warrants a randomized controlled trial. Trial registration: ClinicalTrials.gov. NCT02925481. Registered 10–04-16. [ABSTRACT FROM AUTHOR]

Despite the high rate of infant mortality in Ghana, few studies have explored the maternal experience of infant loss and the perinatal grieving process. As part of a larger study that interviewed 153 mothers with a sick infant, this 1-year follow-up study reinterviewed eight mothers from the original cohort whose infant died since the study began. Mothers were queried about mental health, coping, and cultural issues related to the loss. Mothers were often discouraged from speaking or thinking about the death due to fear of psychological harm and impact on fertility. Primary coping mechanisms involved seeking support within the community and accepting the loss as God's will. Mothers desired more communication from health-care providers at the time of death. Despite the cultural norm of silent acceptance in the face of perinatal loss, intense maternal grief and desire to mourn may allow more opportunities for health-care workers to support bereaved mothers. [ABSTRACT FROM AUTHOR]

Introduction Physicians have high rates of suicide and depression. Most state medical boards require disclosure of mental health problems on physician licensing applications, which has been theorized to increase stigma about mental health and prevent help-seeking among physicians. Methods We surveyed a convenience sample of female physician-parents on a closed Facebook group. The anonymous 24-question survey asked about mental health history and treatment, perceptions of stigma, opinions about state licensing questions on mental health, and personal experiences with reporting. Results 2106 women responded, representing all 50 states and the District of Columbia. Most respondents were aged 30–59. Almost 50% of women believed that they had met the criteria for mental illness but had not sought treatment. Key reasons for avoiding care included a belief they could manage independently, limited time, fear of reporting to a medical licensing board, and the belief that diagnosis was embarrassing or shameful. Only 6% of physicians with formal diagnosis or treatment of mental illness had disclosed to their state. Conclusions Women physicians report substantial and persistent fear regarding stigma which inhibits both treatment and disclosure. Licensing questions, particularly those asking about a diagnosis or treatment rather than functional impairment may contribute to treatment reluctance. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) is a major public health problem estimated to affect 15%–71% of women worldwide. We sought to elicit IPV risks among mothers of sick newborns in Ghana. As part of a broader study on postpartum depression, we conducted semistructured surveys of 153 women in a mother–baby unit, assessing demographics, depression, social support, and IPV with the present partner. Forty-six percent of mothers reported some form of violence, mostly emotional (34%), followed by physical (17%), and sexual (15%). The study highlights the frequency of perinatal IPV and the associated risk factors of depression and poor social support. [ABSTRACT FROM PUBLISHER]

Introduction: Perinatal loss is often a traumatic outcome for families. While there are limited data about depressive outcomes in small populations, information about depression and posttraumatic stress disorder among large racially and economically diverse populations is sparse. Methods: We collaborated with the Michigan Department of Community Health to conduct a longitudinal survey of bereaved mothers with stillbirth or infant death under 28 days of life and live-birth (control) mothers in Michigan. The study assessed 9-month mental health outcomes including self-reported symptoms of depression and posttraumatic stress disorder along with information about demographics, pregnancy and loss experience, social support, and past and present mental health and treatment. Results: Of 1400 women contacted by the State of Michigan, 609 completed surveys and were eligible to participate for a 44% response rate (377 bereaved mothers and 232 control mothers with live births). In multivariable analysis, bereaved women had nearly 4-fold higher odds of having a positive screen for depression and 7-fold higher odds of a positive screen for post-traumatic stress disorder after controlling for demographic and personal risk variables. A minority of screen-positive women were receiving any type of psychiatric treatment. Conclusion: This is the largest epidemiologically based study to date to measure the psychological impact of perinatal loss. Nine months after a loss, bereaved women showed high levels of distress with limited rates of treatment. Symptoms need to be monitored over time for persisting disorder and further research should identify women at highest risk for poor outcomes. [ABSTRACT FROM AUTHOR]