Seeing and holding a stillborn baby: Mothers’ feelings in relation to how their babies were presented to them after birth—Findings from an online questionnaire Kerstin Erlandsson, RN, RM, PhD (Senior Lecturer) a,n , Jane Warland, RN, RM, PhD (Senior Lecturer) b , Joanne Cacciatore, PhD (Social Worker, Professor) c , Ingela R ˚ adestad, RN, RM, PhD (Professor) d a School of Health, Care and Social Welfare, M¨ alardalen University, Eskilstuna/V¨ aster˚ as, Box 883, S-721 23 V¨ aster˚ as, Sweden b School of Nursing and Midwifery, University of South Australia, Adelaide, Australia c School of Social Work, Arizona State University, AZ, USA d Sophiahemmet University College, Stockholm, Sweden article info Article history: Received 29 September 2011 Received in revised form 28 December 2011 Accepted 7 January 2012 Keywords: Stillbirth Birth Midwifery roles Women’s health issues abstract Objective: to determine if the way caregivers offer opportunities to see and hold a stillborn baby impacts a mother’s feelings about the experience of seeing and holding her newborn. Design and setting: a web questionnaire hosted by the Swedish National Infant Foundation from March 2008 to April 2010. Participants: 840 eligible participants who had experienced a stillbirth after the 22nd gestational week from 1955 to 2010 and completed an online questionnaire about their experiences. Methods: descriptive and inferential statistics. Findings: when mothers were presented the baby as a normal part of birth without being asked if they wanted to see, they more often reported that the experience was comfortable compared to mothers who were asked if they wanted to see the baby 86% vs. 76% (p ¼ o0.01). The incitation of fear in mothers was 70% vs. 80% (p ¼0.02) in favour of mothers who were not asked. Furthermore the mothers who were not asked more often stated that it felt natural and good when compared to those who said staff asked if the mother wanted to see, 73% vs. 61% (p ¼0.07) and (78%) vs. (69%) p ¼0.19, respectively. A trend was seen toward more mothers feeling natural, good, comfortable, and less frightened if the provider engaged in ‘assumptive bonding’, that is the baby is simply and naturally presented to the mother without asking her to choose. Key conclusions: mothers of stillborn babies felt more natural, good, comfortable and less frightened if the staff supported assumptive bonding by simply offering the baby to the mother. Implications for practice: care providers should approach caring for grieving mothers with tenderness and humility, assuming that they will wish to see and hold their stillborn baby. & 2012 Elsevier Ltd. All rights reserved. Introduction The birth of a stillborn baby is one of the most evocative of all human experiences despite the fact that the understanding of people’s perception of death and bereavement is related to different cultural influences (Spector, 2002). Health-care provider attitudes and behaviours, as well as the atmosphere surrounding the stillborn baby’s birth, may influence the nature of parents’ contact with their baby. In Sweden as in many other countries during the mid-twentieth century, when both birth and death were institutionalised, health-care professionals took over both the management and rituals of stillbirth (Cacciatore and Flint, 2011). Parents were not usually offered the opportunity to see their stillborn baby because the staff believed that this routine would minimise psychological trauma (Lasker and Toedter, 1994). In the late 1970s, and the early 1980s this practice shifted as a result of both professionals in the field and an outcry from bereaved parents. Standards-of-care and best practice guidelines promoted parents having contact with their babies in order to meet and say farewell to their baby (Lewis, 1979) and stillborn babies were treated as live-born babies concerning respect and tenderness (R˚ adestad et al., 1996). Studies exploring contact with stillborn babies demonstrate positive outcomes in both mothers perception of the experience and in measurable outcomes such as maternal depression and Contents lists available at SciVerse ScienceDirect journal homepage: www.elsevier.com/midw Midwifery 0266-6138/$ - see front matter & 2012 Elsevier Ltd. All rights reserved. doi:10.1016/j.midw.2012.01.007 n Corresponding author. E-mail addresses: kerstin.erlandsson@mdh.se (K. Erlandsson), jane.warland@unisa.edu.au (J. Warland), joanne.cacciatore@asu.edu (J. Cacciatore), ingela.radestad@shh.se (I. R ˚ adestad). Please cite this article as: Erlandsson, K., et al., Seeing and holding a stillborn baby: Mothers’ feelings in relation to how their babies were presented to them after birth—Findings from an online questionnaire. Midwifery (2012), doi:10.1016/j.midw.2012.01.007 Midwifery ] (]]]]) ]]]–]]]