All bereaved parents are entitled to good care after stillbirth: a mixed-methods multicentre study (INSIGHT)

Objective: To understand challenges in care after stillbirth and provide tailored solutions. // Design: Multi‐centre case study. // Setting: Three maternity hospitals. // Population: Parents with a stillborn baby, maternity staff. // Methods: Thematic analysis of parent interviews and staff focus groups and service provision investigation. // Outcomes: 1 Themes; 2 Triangulation matrix; 3 Recommendations. // Results: Twenty‐one women, 14 partners, and 22 staff participated. // Service Provision: Care for parents after stillbirth varies excessively; there are misconceptions; post‐mortem does not delay follow‐up. // Presentation: Women ‘do not feel right’ before stillbirth; their management is haphazard and should be standardised. // Diagnosis: Stillbirth is an emergency for parents but not always for staff; communication can seem cold; well‐designed bereavement space is critical. // Birth: Staff shift priorities to mother and future, but for parents their baby is still a baby; parents are not comfortable with staff recommending vaginal birth as the norm; there are several reasons why parents ask for a caesarean; better care involves clear communication, normal behaviour, and discussion of coping strategies. // Post‐mortem: Parents are influenced by discussions with staff. Staff should ‘sow seeds’, clarify its respectful nature, delineate its purpose, and explain the timescale. // Follow‐up: It is not standardised; parents wish to see their multi‐professional team. // Conclusions: There is unacceptable variation in care after stillbirth, and insensitive interactions between staff and bereaved parents. Understanding parents' needs, including why they ask for caesarean birth, will facilitate joint decision‐making. Every bereaved parent is entitled to good, respectful care