Kerstin Erlandsson

Parental grief and relationships after the loss of a stillborn baby

OBJECTIVES to describe the grief of mothers and fathers and its influence on their relationships after the loss of a stillborn baby. DESIGN a postal questionnaire at three months, one year and two years after stillbirth. SETTING a study of mothers and fathers of babies stillborn during a one-year period in the Stockholm region of Sweden. PARTICIPANTS 55 parents, 33 mothers and 22 fathers. FINDINGS mothers and fathers stated that they became closer after the loss, and that the feeling deepened over the course of the following year. The parents said that they began grieving immediately as a gradual process, both as individuals, and together as a couple. During this grieving process their expectations, expressions and personal and joint needs might have threatened their relationship as a couple, in that they individually felt alone at this time of withdrawal. While some mothers and fathers had similar grieving styles, the intensity and expression of grief varied, and the effects were profound and unique for each individual. KEY CONCLUSIONS experiences following a loss are complex, with each partner attempting to come to terms with the loss and the resultant effect on the relationship with their partner. IMPLICATIONS FOR PRACTICE anticipating and being able to acknowledge the different aspects of grief will enable professionals to implement more effective intervention in helping couples grieve both individually and together.

Fathers' lived experiences of getting to know their baby while acting as primary caregivers immediately following birth.

The aim of this study was to describe the meaning of the father’s lived experiences when taking care of his infant as the primary caregiver during the first hours after birth, when the infant was apart from the mother due to the mother’s postoperative care. Fifteen fathers were interviewed between 8 days and 6 weeks after the birth. The results describe a movement toward father-child togetherness characterized by an immediate and gradual change within the father as he undertakes increasing responsibility while getting to know his child. The results can be discussed in antenatal classes in order to integrate the father’s important role in the care of his infant, especially in a situation where the mother-infant dyad has been interrupted.

Support After Stillbirth and Its Effect on Parental Grief Over Time

In this study the authors describe parents’ experiences of support over a 2-year period after a stillbirth and its effect on parental grief. Data was collected by questionnaire from 33 mothers and 22 fathers at 3 months, 1 year, and 2 years after a stillbirth. Midwives, physicians, counselors, and priests—at the hospital where the stillbirth occurred—are those on the front line providing professional support. The support from family and friends was seen to be important 2 years after the stillbirth. The need for professional support after stillbirth can differ, depending on the support provided by family, friends, and social networks. They may not fully realize the value of their support and how to be supportive. Printed educational materials given to individuals in the social network or family might therefore be helpful.

Women's premonitions prior to the death of their baby in utero and how they deal with the feeling that their baby may be unwell

Objective. To identify whether mothers of stillborn babies had had a premonition that their unborn child might not be well and how they dealt with that premonition. Design. A mixed method approach. Setting. One thousand and thirty‐four women answered a web questionnaire. Sample. Six hundred and fourteen women fulfilled the inclusion criteria of having a stillbirth after the 22nd gestational week and answered questions about premonition. Methods. Qualitative content analysis was used for the open questions and descriptive statistics for questions with fixed alternatives. Main Outcome Measure. The premonition of an unwell unborn baby. Results. In all, 392 of 614 (64%) of the women had had a premonition that their unborn baby might be unwell; 274 of 614 (70%) contacted their clinic and were invited to come in for a check‐up, but by then it was too late because the baby was already dead. A further 88 of 614 (22%) decided to wait until their next routine check‐up, believing that the symptoms were part of the normal cycle of pregnancy, and that the fetus would move less towards the end of pregnancy. Thirty women (8%) contacted their clinic, but were told that everything appeared normal without an examination of the baby. Conclusions. Women need to know that a decrease in fetal movements is an important indicator of their unborn babys health. Healthcare professionals should not delay an examination if a mother‐to‐be is worried about her unborn babys wellbeing.

Prenatal parental education from the perspective of fathers with experience as primary caregiver immediately following birth: a phenomenographic study.

The aim of this phenomenographic study was to capture fathers’ conceptions of parental education topics, illuminated by their experiences as primary caregiver of their child immediately following birth. Fifteen fathers were interviewed between 8 days and 6 weeks after the birth of their child. Three categories, five subcategories, and 12 qualitatively different conceptions emerged from the study’s findings. The first category showed that parental education emphasizes the importance of normal birth. The second category illustrated that parental education defuses the issue of complicated births. The third category demonstrated that parental education preserves traditional gender roles. The study’s results may facilitate efforts to integrate fathers into parental education toward the aim of achieving parity between mother and father in their role as parents.

Siblings’ farewell to a stillborn sister or brother and parents’ support to their older children: A questionnaire study from the parents’ perspective

This study aims to capture parental descriptions of how siblings take leave of and mourn a stillborn brother or sister and how their parents support them. Data were collected by questionnaires from 16 parents of siblings to a stillborn child one year after the stillbirth. Data were analysed numerically for the multiple-choice questions and content analysis was used for parental comments and descriptions. The results describe siblings’ farewell to a stillborn brother or sister and how their parents in the midst of their own grief were involved in supporting siblings’ wellbeing, and observed their mourning reactions. Although the findings need to be interpreted with caution, they may provide insight that enables staff to become more sensitive to the whole family experience in the practice of their profession. Further research into siblings’ grief and parental support after stillbirth is crucial so that further light may be shed on their situation.

Rebuilding research capacity in fragile states: the case of a Somali–Swedish global health initiative

ABSTRACT This paper presents an initiative to revive the previous Somali–Swedish Research Cooperation, which started in 1981 and was cut short by the civil war in Somalia. A programme focusing on research capacity building in the health sector is currently underway through the work of an alliance of three partner groups: six new Somali universities, five Swedish universities, and Somali diaspora professionals. Somali ownership is key to the sustainability of the programme, as is close collaboration with Somali health ministries. The programme aims to develop a model for working collaboratively across regions and cultural barriers within fragile states, with the goal of creating hope and energy. It is based on the conviction that health research has a key role in rebuilding national health services and trusted institutions.

Qualitative Interviews with Adolescents about "Friends-with-Benefits" Relationships

OBJECTIVE To describe the thoughts, reflections, and experiences of friends-with-benefits relationships among a group of Swedish adolescents. DESIGN AND SAMPLE A qualitative study with an explorative and descriptive design. Eight adolescents, aged 16-18, were interviewed. MEASURES Individual in-depth interviews were undertaken. Data were analyzed using latent content analysis. RESULTS The informants involved themselves in Friends-with-benefits (FWB) relationships to find physical and psychological intimacy without any expectations or demands. FWB relationships were perceived to have more advantages when the partner was a close friend with whom an informant felt comfortable. There was ambivalence about the legitimacy of romantic feelings in an FWB relationship, although it was quite common. Sexual concurrency was common and often accepted. Sexual risk-taking behavior involving the use of alcohol and a lack of contraception was considered common in FWB relationships. Informants requested more education and support as regards their sexual behavior. CONCLUSIONS FWB relationships were often initiated to find physical and psychological intimacy with no expectations or demands. Advantages such as sexual concurrency and no demands were central. A deeper understanding of how adolescents think and reason about sexuality and relationships can make a difference when working to improve young peoples sexual and reproductive health.

Being a resource for both mother and child: fathers' experiences following a complicated birth.

The aim of this study was to describe fathers’ experiences of being present on a postnatal ward and during the first days at home following a complicated birth. Fifteen fathers were interviewed, and content analysis was used for the analysis. The theme illustrated that fathers were a resource for both mother and child through practical and emotional engagement. The categories describe how the father empowers the mother and illustrates adapting to new family roles. Following complicated birth, fathers should be invited to stay around-the-clock on postnatal wards because it gives them the opportunity to place their resources at the disposal of mother and child. In antenatal courses, fathers should be prepared for their empowering role after a complicated birth.

Make the stillborn baby and the loss real for the siblings: parents' advice on how the siblings of a stillborn baby can be supported.

This study aimed to investigate parents’ advice to other parents on the basis of their own experiences of siblings’ taking leave of a stillborn sister or brother. The study was a Web questionnaire study of 411 parents. The thematic content analysis resulted in two categories: “Make the stillborn baby and the loss real for the siblings” and “Take the siblings’ resources and prerequisites into account.” Parents’ advised that siblings should see and hold the stillborn baby and, thus, be invited and included into the leave-taking process with respect to the siblings’ feelings, resources, and prerequisites. Based on these findings, professional caregivers can usefully be proactive in their approach to facilitate and encourage the involvement of siblings.