Holding stillborns 'adds to misery'

Mothers in their second pregnancy were studied

Guidance which encourages mothers to see and hold their stillborn babies may make the experience more traumatic for them, research suggests.

Researchers have found some mothers who had contact with their baby were not helped to grieve, and some actually felt worse.

Around 0.5% of babies born in developed countries are stillborn.

Expert guidelines introduced in the mid-1980s say mothers should be encouraged to see and hold their child to help them come to terms with their loss.

There should be absolutely no pressure on parents to see their baby

Dr Patricia Hughes, St George's Hospital Medical School

Parents are also encouraged to hold a funeral for the baby and keep mementos.

Prior to that, the baby was removed in an attempt to prevent the parents becoming distressed.

Bonding problems

Researchers from St George's Hospital Medical School, London looked at whether these rules actually benefited parents.

They studied 65 women who were pregnant for a second time who had previously had a stillborn baby.

It was found 39% of women who saw and held their babies later experienced depression, compared with 21% of those who only saw the infant.

Just 6% of women who neither saw or held their stillborn child were depressed.

Women who had seen their stillborn infant had greater anxiety and higher symptoms of post traumatic stress disorder.

And they were over five times more likely to have trouble bonding with their subsequent child compared to those mothers who had not seen their child.

In a paper in the Lancet, the researchers wrote; "We speculate that sometimes, rather than creating memories which help the recovery process, seeing and holding the dead infant further traumatises a woman who is already intensely distressed and physically exhausted.

"Furthermore, we note some women are left with images that haunt them afterwards."

Time

Dr Patricia Hughes, a senior lecturer in psychiatry at St George's Hospital Medical School told BBC News Online some people did not want to see their baby, but were persuaded to do so.

She said: "There should be absolutely no pressure on parents to see their baby."

Dr Hughes added: "Staff need to be very, very sensitive to what the mums and dads can cope with.

When the college produced its guidance, there was a need to emphasise the importance of giving parents the opportunity to see and hold their baby if they wished.

Royal College of Obstetricians and Gynaecologists spokesman

"They need to be given lots of time to decide and not rushed into anything - and to be told that seeing the baby is right for some people, but not for others."

She said staff may sometimes adhere to the guidelines as the "right" way of doing things if they feel at a loss as to what to do, rather than being sensitive to the needs of parents.

The team hoped more research would be carried out looking at a larger group of women, and to examine how fathers coped with having a stillborn baby.

Grieving process

Erica Stewart, spokeswoman for the Stillbirth and Neonatal Death Society (Sands), said: "Parents need to feel that the process of grieving both for a dead baby, or a baby who dies in the neonatal unit

"The chance to bathe your baby, cuddle it or dress the baby, it does bring parents a better sense of closure.

Ms Stewart, who lost a baby herself said: "From my own experience, and speaking to a vast number of bereaved parents, they have really benefited from that.

"I don't think parents should be forced to hold their babies and see their babies. They should have the choice."

A spokesperson for the Royal College of Obstetricians and Gynaecologists, which drew up the guidelines, said: "This is an important study and has gathered important evidence in a difficult area.

"In 1985, when the college produced its guidance, there was a need to emphasize the importance of giving parents the opportunity to see and hold their baby if they wished.

"The view expressed in this study is that not all parents may wish to do this.

"However, it is important that those that do wish to hold their baby are given every opportunity to take leave of their baby in the way that they wish."