Psychological impact of stillbirths on obstetricians

Abstract

Objective: To assess the psychological impact on US obstetricians when they care for women who have suffered a stillbirth and explore whether demographic (e.g. age, gender) and practice (e.g. number of patients, practice type) variables were related to the extent of psychological impact for obstetricians following stillbirth.

Methods: Using a questionnaire that could be completed in about 20?min, we surveyed 1000 American College of Obstetricians and Gynecologists (ACOG) members. Physicians were asked about how stillbirths have affected them personally.

Results: Half of those surveyed responded (499) and of those 365 currently practiced obstetrics. Virtually all obstetricians have looked after women who have had a stillbirth. Grief was the most common reaction experienced with 53.7% reporting that they personally “very much” experienced grief. Other common and significant reactions were self-doubt (17.2%), depression (16.9%) and self-blame (16.4%). Significant psychological impact on the obstetrician was associated with older age, solo practice, higher volume practices and higher proportion of Medicaid patients; gender was not found to be associated with psychological impact when controlling for age. Further, greater self-reported performance and training regarding maternal and family counseling, management of stillbirth, and knowledge of stillbirth evaluation was associated with greater levels of grief.

Conclusion: Physician grief is a common reaction among obstetricians after caring for a patient who has had a stillbirth.