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not-yet-known not-yet-known not-yet-known unknown Factors Contributing to Uptake of Stillbirth Evaluations: A Qualitative Analysis
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  • Naomi O. Riches,
  • Tsegaselassie Workalemahu,
  • Erin P. Johnson,
  • Sarah Lopez,
  • Nathan Blue,
  • Jessica Page,
  • Robert Silver (USA),
  • Erin Rothwell
Naomi O. Riches
The University of Utah Department of Obstetrics and Gynecology

Corresponding Author:naomi.riches@hsc.utah.edu

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Tsegaselassie Workalemahu
The University of Utah Department of Obstetrics and Gynecology
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Erin P. Johnson
The University of Utah Department of Obstetrics and Gynecology
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Sarah Lopez
The University of Utah Department of Obstetrics and Gynecology
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Nathan Blue
The University of Utah Department of Obstetrics and Gynecology
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Jessica Page
The University of Utah Department of Obstetrics and Gynecology
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Robert Silver (USA)
The University of Utah Department of Obstetrics and Gynecology
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Erin Rothwell
The University of Utah Department of Obstetrics and Gynecology
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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.
29 Aug 2024Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
30 Aug 2024Submission Checks Completed
30 Aug 2024Assigned to Editor
30 Aug 2024Review(s) Completed, Editorial Evaluation Pending
20 Sep 2024Reviewer(s) Assigned