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Care Around Stillbirth and Neonatal Death (CASaND) Clinical Practice Guideline

Approach to care

Background

The death of a baby during pregnancy or soon after birth has long-lasting social and emotional consequences for parents and families/whānau, and wide-ranging economic impacts on health systems and society both globally and in Australia and Aotearoa New Zealand.1,2 The quality of care that parents and family/whānau receive around the time that their baby dies is a major contributor to immediate and long-term wellbeing, including into subsequent pregnancies.3,4

This section of the guideline outlines an optimal approach to care around stillbirth and neonatal death. This includes an organisational framework that sets out six core goals of care, which are interrelated and relevant to bereaved parents and family/whānau. Comprehensive care in the context of perinatal loss is multifaceted and interdisciplinary.5,6 This framework contributes to the overall goals and experience of care.7

“When my baby died, I had no idea what I needed to know, or what was possible. It was such an overwhelming time. What I really needed was to know the options I had so that we could make decisions that were right for us.”

Parent quote from the Guiding Conversations booklet.

Objective

This section aims to assist frontline healthcare professionals to provide high quality and comprehensive care and support to parents and family/whānau following the death of a baby before or soon after birth.

The evidence synthesis of this section includes care of parents who have experienced stillbirth or neonatal death, including stillbirths and neonatal deaths following termination of pregnancy.

This guideline acknowledges all parents and family/whānau who have experienced the death of a baby during pregnancy or soon after birth including early pregnancy loss. Implementation of these recommendations will ensure high quality consistent care for all parents and family/whānau who are cared for in maternal or newborn settings, regardless of when or where their baby dies.

A note about terminology

This guideline uses parent-centred language that is intended to be inclusive of all affected by loss. We use the term ‘woman’ throughout the guideline to refer to the person who is pregnant and gives birth.8 We acknowledge diverse gender identities and that not all individuals who become pregnant and give birth identify as a woman. The term ‘parent’ is used to refer to expectant and bereaved mothers, fathers, and partners. It is important to recognise individuals who identify themselves as parents. However, we also acknowledge that not all individuals who experience perinatal loss consider themselves to be parents.9

This guideline uses ‘baby’ when referring to stillbirth and neonatal death because these terms are preferred by many bereaved parents. Terms such as ‘fetus’ may add to parents’ distress because this language denies personhood10 and is inconsistent with recognition of parenthood that is crucial to providing respectful and supportive care.

This guideline uses ‘healthcare professional’ to denote all those working with bereaved parents and family/whānau (see Glossary).

Section 1 references
Framework for care around stillbirth and neonatal death
Stillbirth Logo
Western Pacific Regional Office of the International Stillbirth Alliance
Coordinating Centre, Stillbirth and Neonatal Death Alliance, Perinatal Society of Australia and New Zealand

Level 3, Aubigny Place
Mater Research Institute
Raymond Terrace,
South Brisbane QLD 4101
The University of Queensland Faculty of Medicine

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