Postpartum Care After Stillbirth: Exploring Factors Associated with Postpartum Visits and Perinatal Bereavement Interventions

Abstract

Postpartum care after stillbirth has historically received less attention in both research and clinical guidelines than care following live births. In the US, as many as 24,000 babies are stillborn each year. Significant racial and ethnic inequities in the rate of stillbirth also exist. Black birthing people are more than twice as likely to experience a stillbirth compared with Hispanic and White birthing people. Birthing people who experience stillbirth face significantly higher risk for depression, anxiety, and postpartum stress disorder (PTSD) compared with birthing people who have a live birth. Yet, a dearth of literature on postpartum care after stillbirth exists. The overall aim of this dissertation is to address some of the existing gaps in literature on postpartum care after stillbirth. First, I use data from the Study of Associated Risks of Stillbirth (SOARS) to explore factors associated with postpartum visit (PPV) attendance among birthing people who had a stillbirth. Then I conducted a series of focus groups with Black birthing parents to provide an in-depth qualitative understanding of stillbirth experiences. Finally, I conducted a systematic review of the literature on perinatal bereavement interventions to synthesize the available evidence on hospital or clinic-based perinatal bereavement interventions. Collectively, findings from these studies address significant gaps in the literature on stillbirth. I discuss the implications of these findings on future research.