ResearchObstetricsNational survey of obstetrician attitudes about timing the subsequent pregnancy after perinatal death
Section snippets
Materials and Methods
The study was a national mail survey to 1500 US obstetricians, selected through simple random sampling from the American Medical Association (AMA) Physician Masterfile and confirmed to hold an active US medical license. The Physician Masterfile includes data on all US physicians, including both those who are AMA members and those who are not. It also includes data for graduates of foreign medical schools who live in the United States. Physicians were initially sent the 51-question survey along
Results
Of 1500 mailings, 19 subjects were replaced due to undeliverable envelopes and 15 mailings came back undeliverable after the study ended and these subjects were not replaced. Of the remaining 1485 subjects, 34 physicians returned a form declining to participate, 2 incompletely filled out the survey, and 804 completed the full survey for a usable response rate of 54%.
Respondents were nearly equally split between male and female, and median age was 46 years with 14 years of practice after
Comment
This study highlights physician recommendations for brief IPI after a stillbirth. The majority of studies that have examined IPIs have reported the best perinatal outcomes for pregnancies conceived at least 6 months and perhaps as much as ≥18 months after a previous pregnancy.1, 2, 3, 10 In this survey, less than a third of physicians recommended that parents bereaved by stillbirth wait ≥6 months prior to trying for conception. This is an important finding and warrants additional exploration of
References (45)
Impact of prior perinatal loss on subsequent pregnancies
J Obstet Gynecol Neonatal Nurs
(2004)- et al.
Pregnancy after perinatal loss: the relationship between anxiety and prenatal attachment
J Obstet Gynecol Neonatal Nurs
(1998) - et al.
The impact of perinatal loss on adjustment to subsequent pregnancy
Soc Sci Med
(1999) - et al.
The influence of interpregnancy interval on the subsequent risk of stillbirth and early neonatal death
Obstet Gynecol
(2003) Psychologic and obstetric predictors of couples' grief during pregnancy after miscarriage or perinatal death
Obstet Gynecol
(2001)- et al.
Resolution of parental bereavement after a perinatal loss
J Am Acad Child Adolesc Psychiatry
(1990) - et al.
Postponing pregnancy after perinatal death: perspectives on doctor advice
J Am Acad Child Adolesc Psychiatry
(1989) - et al.
Birth spacing and risk of adverse perinatal outcomes
JAMA
(2006) - et al.
Short interpregnancy intervals and the risk of adverse birth outcomes among five racial/ethnic groups in the United States
Am J Epidemiol
(1998) - et al.
Interpregnancy interval and risk of preterm birth and neonatal death: retrospective cohort study
BMJ
(2003)
Effect of interpregnancy interval on infant low birth weight: a retrospective cohort study using the Michigan maternally linked birth database
Matern Child Health J
Association of birth outcome with subsequent fertility
Am J Obstet Gynecol
Prediction and prevention of recurrent stillbirth
Obstet Gynecol
Stillbirth recurrence in a population of relatively low-risk mothers
Paediatr Perinat Epidemiol
Obstetric outcomes subsequent to intrauterine death in the first pregnancy
BJOG
Interpregnancy interval and subsequent perinatal outcomes among women delaying initiation of childbearing
J Obstet Gynaecol Res
Effect of the interval between pregnancies on perinatal outcomes
N Engl J Med
Emotional distress and prenatal attachment in pregnancy after perinatal loss
J Nurs Scholarsh
Women's voices reflecting changed expectations for pregnancy after perinatal loss
J Nurs Scholarsh
The impact of a subsequent pregnancy on grief and emotional adjustment following a perinatal loss
Infant Ment Health J
The subsequent pregnancy after stillbirth: anticipatory parenthood in the face of uncertainty
Int J Psychiatry Med
Watching and worrying: early pregnancy after loss experiences
MCN Am J Matern Child Nurs
Cited by (18)
Postpartum Care and Long-Term Health Considerations
2016, Obstetrics: Normal and Problem PregnanciesEffectiveness of an educational intervention on the suitability of indications for cesarean delivery in a Brazilian teaching hospital
2015, International Journal of Gynecology and ObstetricsCitation Excerpt :The saying “once cesarean always cesarean” that dominated obstetric practice in the USA in the mid-1970s led the American College of Obstetricians and Gynecologists to develop a guideline for vaginal birth after previous cesarean delivery [10]. That protocol has been accepted as a means of reducing the incidence of cesarean delivery and morbidity rates resulting from the procedure [11,17]. Implementing behavioral models on the basis of the highest level of evidence could be a way of reducing cesarean rates in practice [18].
Managing adverse birth outcomes: Helping parents and families cope
2012, American Family PhysicianCitation Excerpt :Genetic testing may also be performed postpartum using placental tissue or fetal blood.1 Studies have documented increased psychological distress during subsequent pregnancies when grief over a previous adverse birth outcome had not been acknowledged or resolved through normal socially approved processes.2,29 Asynchronous grief between the parents may also lead to discordant recovery and varying expectations.20,23
Decision-making and future pregnancies after a positive fetal anomaly screen: A scoping review
2023, Journal of Clinical NursingStillbirth and subsequent pregnancy outcome - A cohort from a large tertiary referral hospital
2020, Journal of Perinatal Medicine
Cite this article as: Gold KJ, Leon I, Chames MC. National survey of obstetrician attitudes about timing the subsequent pregnancy after perinatal death. Am J Obstet Gynecol 2010;202:357.e1-6.
This study was supported by the Department of Obstetrics and Gynecology, University of Michigan Medical School, with salary support for Dr Gold provided by a National Institutes of Health K-12 Building Interdisciplinary Research Careers in Women's Health Grant.