Physicians' attitudes and advice concerning pregnancy subsequent to the birth of a stillborn child.

The aim of this study was to identify physicians' approaches to pregnancy subsequent to the birth of a stillborn child. In a 48-question, cross-sectional survey performed in 1997 one specific question dealt with advice given to the women/parents about possible subsequent pregnancy. The present study analyzes the responses to that open-ended question. Fifty-eight out of 61 Swedish hospitals with departments of obstetrics and gynecology participated in the study. Of 594 physicians, 552 answered the open-ended question (93%) with 802 items of advice. The most frequent approach to subsequent pregnancy, expressed by a majority of physicians, was their own support to the couples (59%). Regarding gender differences the females were more likely to mention support strategies than their colleagues (p = 0.005). Significantly more female gynecologists than male (p = 0.005) recommended care during the new pregnancy at a special antenatal clinic. The statement that 'advice depends on diagnosis' was made by 27%, while 22% advocated that parents first work through the grief of the stillbirth (mentioned significantly more often by females, p = 0.014). A minority of physicians mention giving specific advice about the timing of next pregnancy. The study highlights physicians' concerns to support parents through a subsequent pregnancy whilst demonstrating that considerable variation exists in their advice, or lack of it, with regard to timing of another pregnancy.