Study Looks at Stillborns, Mourning
By JILL LAWLESS
Associated Press Writer

LONDON (AP) - Mothers who see and hold their stillborn infants may suffer more psychological trauma than those who don't, a new study suggests - contradicting years of medical advice to bereaved parents.

The research also found that next-born children are more likely to have psychological problems if their mothers held or saw their stillborn sibling.

``Our result suggests there is no justification for telling parents that not seeing their dead baby could make mourning more difficult, and that those who are reluctant to see and hold their child should not be encouraged to do so,'' said the study's primary author, Dr. Patricia Hughes.

Several experts welcomed the findings, but Erica Stewart, spokeswoman for Britain's Stillbirth and Neonatal Death Society, said they contradicted her experience with mothers who had lost a child.

``We take calls from mums who lost babies in the 1930s, '40s, '50s and '60s, and they're wanting to deal with it now because it was never acknowledged at the time,'' she said. ``They had no closure.''

Published this week in British medical journal The Lancet, the study assessed 65 women in Britain who were pregnant for a second time after a stillbirth.

Thirty-nine percent of those who had seen and held their dead baby suffered depression during pregnancy or in the following year, compared to 21 percent of those who had only seen the infant. Just 6 percent of those who had neither seen nor held their baby were depressed.

About 0.5 percent of pregnancies in developed countries end in stillbirth, which in the study was defined as spontaneous pregnancy loss after 18 weeks gestation or more.

For decades stillborn infants were quickly removed to avoid distressing the parents, but since 1985 guidelines for British medical staff have suggested encouraging mothers to see and hold their children as a way to help the grieving process.

The Royal College of Obstetricians and Gynecologists advises that ``parents may need to be informed that if they do not see their baby they may regret it as it could make mourning more difficult.''

The advice is widely followed - almost three-quarters of the mothers in the study had seen their stillborn babies, while just over half had also held them.

There is no national standard on handling stillbirth in the United States. An increasing number of Americans feel their loss is not properly acknowledged, and residents in several states are lobbying governments to issue stillbirth certificates. Arizona, Indiana and Utah already do so.

In the study, women who had seen and held their infants suffered greater anxiety and greater symptoms of post-traumatic stress disorder than those who had not.

The study also found that 42 percent of next-born children whose mothers had had contact with a stillborn sibling suffered problems in mother-child bonding at 12 months, compared to only 8 percent among children whose mothers had not.

Dr. Cathy Spong, chief of the pregnancy and perinatology branch at the U.S. National Institute for Child Health and Human Development in Bethesda, Md., said the study was an eye-opening contribution to an under-researched field.

``We encourage parents to see their baby and hold their baby - common sense suggests it would be beneficial. I'd never really thought it might be harmful,'' she said.

``Certainly there are limitations to the study, as there are with any study. But it brings forward a good case for further research.''

Phillip Hodson, a psychotherapist and spokesman for the British Association for Counseling and Psychotherapy, said he was not surprised by the study's results.

``All our psychologies differ,'' he said. ``For many people, it's important to face the loss, to have a symbol and a totem. ... For some people, the experience of loss is enough.''

Hughes, a consultant and senior lecturer in psychiatry at St. George's Hospital Medical School in London, said it was crucial that medical staff listened to parents' wishes.

``There has to be huge sensitivity to the needs of the parents, and absolutely no pressure on them,'' she said.
 

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