Perinatal bereavement care during COVID-19 in Australian maternity settings.

Julie H Dean,Aditi Lohan,Philippa Middleton,Dell Horey,Vicki Flenady,Frances M Boyle

doi:10.1515/jpm-2021-0441

Abstract

Perinatal bereavement care is a complex area of practice. The COVID-19 pandemic led to reconfiguration of maternity and perinatal bereavement care services. This study explores Australian health care providers' perspectives of the impact of COVID-19 on the provision of respectful and supportive care following stillbirth or neonatal death. Members of a perinatal bereavement care network were consulted at the commencement of the pandemic in Australia using an online feedback form. Respondents provided ratings and free-text comments on the impact of COVID-19 on implementation of 49 recommendations contained in the Perinatal Society of Australia and New Zealand/Stillbirth Centre of Research Clinical Practice Guideline for Respectful and Supportive Perinatal Bereavement Care. Responses were received from 35 health care providers who provided perinatal bereavement care in clinical settings or through support organisations in Australia. Major impacts of COVID-19 were reported for 8of49 guideline recommendations. Impacts included reduced: support for mothers due to visitor restrictions; availability of cultural and spiritual support and interpreters; involvement of support people in decision-making; options for memory-making and commemorative rituals; and staff training and supervision. Adaptations to minimise impacts included virtual consultations, online staff training, use of cold cots, and increased staff support for memory-making. Health care providers encounter substantial challenges as they strive to implement best practice perinatal bereavement care in pandemic conditions. Some practice adaptations developed during the COVID-19 pandemic could benefit parents; however, evaluation of their effectiveness and acceptability is needed.

Highlights

This study explores Australian health care providers’ perspectives of the impact of COVID-19 on the provision of respectful and supportive care following stillbirth or neonatal death
Respondents provided ratings and free-text comments on the impact of COVID-19 on implementation of 49 recommendations contained in the Perinatal Society of Australia and New Zealand/Stillbirth Centre of Research Clinical Practice Guideline for Respectful and Supportive Perinatal Bereavement Care
Responses were received from 35 health care providers who provided perinatal bereavement care in clinical settings or through support organisations in Australia

Summary

Introduction

The complex area of perinatal bereavement care faces many further challenges with the COVID-19 pandemic as maternity services reconfigure to contain the spread of the virus. COVID-19 related changes to maternity services have led to reports from women and their partners of reduced support and feeling isolated, stressed, anxious, fearful and sad [3,4,5,6,7]. Perinatal loss has both short- and long-term psychological and social consequences for families [8,9,10], that may be intensified and compounded by physical and social distancing restrictions during the current pandemic. There appears to be no published research on the impact of COVID-19 on perinatal bereavement, though reports from multiple sources confirm the high need for both formal and informal support at this highly distressing time [15, 16]

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Results

Conclusion