Quality assessment of medical care for females with stillbirth according to a questionnaire

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access


BACKGROUND: Death is a leading factor in post-traumatic stress disorder development. The adequacy of medical and psychological support for childbirth with a dead fetus plays a key role in severe psychological disorder prevention.

MATERIALS AND METHODS: The authors have developed a questionnaire to assess the quality of obstetric, anesthesiological, and psychological assistance to females with death. The questionnaires of 173 respondents were analyzed. The duty factor or completeness of answers was 0.96. Of the cases, 55% of childbirth with a dead fetus occurred after 34 weeks of gestation, whereas the time interval from the moment of delivery to the questionnaire did not exceed 2 years in 60% of cases.

RESULTS: The heavy emotional state was rated by 70% of females. Psychological assistance was recognized as unsatisfactory in 52% of cases. Most females (63%) wanted to be conscious at the time of the birth of a child and contact with him. This issue was not discussed with females in labor in 51% of cases. Neuroaxial methods of analgesia were used in 36% of cases in vaginal childbirth, whereas anesthesia was not performed in 40% of patients. Sedative therapy was needed by 76% of females in the postpartum period, which was prescribed only in 25% of cases. A third of respondents rated unsatisfactory medical care provided, and 94% of females believe that special training and seminars on communication with patients who have had a stillbirth are necessary for medical workers.

CONCLUSION: The analysis of questionnaires filled out by women with stillbirth revealed several problems in the quality of medical care provided to them, wherein the most significant was the insufficient realization of the patient’s desire for contact with a dead child, insufficient anesthesia in childbirth, and sedation in the postpartum period, as well as unsatisfactory psychological care provided by doctors of an interdisciplinary team and a clinical psychologist, according to respondents.

Full Text

Restricted Access

About the authors

Yulya S. Mysovskaya

Saratov City Clinical Hospital № 1 named after Yu.Ya. Gordeev

Author for correspondence.
Email: yulya-mys@yandex.ru
ORCID iD: 0000-0002-0544-7886


Russian Federation, 19 Kholzunova str., 410017, Saratov

Dmitriy V. Marshalov

Saratov State Medical University named after V.I. Razumovsky

Email: marshald@mail.ru
ORCID iD: 0000-0002-8774-0700

M.D., Dr. Sci. (Med.), Associate Professor

Russian Federation, 19 Kholzunova str., 410017, Saratov

Efim M. Shifman

M.F. Vladimirskiy Moscow Regional Research Clinical Institute

Email: eshifman@mail.ru
ORCID iD: 0000-0002-6113-8498

M.D., Dr. Sci. (Med.), professor

Russian Federation, Moscow

Aleksandr V. Kuligin

Saratov State Medical University named after V.I. Razumovsky

Email: avkuligin@yandex.ru
ORCID iD: 0000-0001-5705-215X

M.D., Dr. Sci. (Med.), Associate Professor

Russian Federation, 19 Kholzunova str., 410017, Saratov

Ekaterina E. Zeulina

Saratov State Medical University named after V.I. Razumovsky

Email: zeulina@list.ru
ORCID iD: 0000-0003-1297-5123

MD, Cand. Sci. (Med.), Associate Professor

Russian Federation, 19 Kholzunova str., 410017, Saratov


  1. Lokugamage AU, Pathberiya SD. Human rights in childbirth, narratives and restorative justice: a review. Reprod Health. 2017;14(1):17. doi: 10.1186/s12978-016-0264-3
  2. Lalonde A, Herschderfer K, Pascali-Bonaro D, et al. The International Childbirth Initiative: 12 steps to safe and respectful MotherBaby-Family maternity care. Int J Gynaecol Obstet. 2019;146(1):65–73. doi: 10.1002/ijgo.12844
  3. Bohren MA, Tunçalp Ö, Miller S. Transforming intrapartum care: Respectful maternity care. Best Pract Res Clin Obstet Gynaecol. 2020;67:113–126. doi: 10.1016/j.bpobgyn.2020.02.005
  4. Mysovskaya YuS, Marshalov DV, Shifman EM, Shindyapina NV. Medical and psychological support of women with stillbirth in the perinatal period: a national study. Regional Anesthesia and Acute Pain Management. 2020;14(4):176–184. (In Russ). doi: 10.17816/1993-6508-2020-25-3-176-184
  5. Mysovskaya YuS, Marshalov DV, Shifman EM, Shindyapina NV, Ioskovich A. Management of childbirth with a dead fetus: differences in the views of obstetricians-gynecologists and anesthesiologists-resuscitators. Results of an interdisciplinary survey. Annals of Critical Care. 2021;1:116–122. (In Russ). doi: 10.21320/1818-474X-2021-1-116-122
  6. Kravchuk AA, Chukhlovina SA, Morgoyeva DA. Comparative analysis of attitudes to death in different religions of the world. Nauchnyi ehlektronnyi zhurnal Meridian. 2019;13(31):258–260. (In Russ).
  7. Queensland Clinical Guideline: Stillbirth care. 2019. https://www.health.qld.gov.au/__data/assets/pdf_file/0023/143087/g-stillbirth.pdf
  8. Eysenbach G. Correction: Improving the Quality of Web Surveys: the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). J Med Internet Res. 2012;14(1):e8. doi: 10.2196/jmir.2042
  9. Burns KE, Duffett M, Kho ME, et al. A guide for the design and conduct of self-administered surveys of clinicians. CMAJ. 2008;179(3):245–252. doi: 10.1503/cmaj.080372
  10. Kelley K, Clark B, Brown V, Sitzia J. Good practice in the conduct and reporting of survey research. Int J Qual Health Care. 2003;15(3):261–266. doi: 10.1093/intqhc/mzg031
  11. Moraes GP, Lorenzo L, Pontes GA, Montenegro MC, Cantilino A. Screening and diagnosing postpartum depression: when and how? Trends Psychiatry Psychother. 2017;39(1):54–61. doi: 10.1590/2237-6089-2016-0034
  12. Tseng YF, Hsu MT, Hsieh YT, Cheng HR. The meaning of rituals after a stillbirth: A qualitative study of mothers with a stillborn baby. J Clin Nurs. 2018;27(5–6):1134–1142. doi: 10.1111/jocn.14142
  13. Tylee MJ, Rubenfeld GD, Wijeysundera D, et al. Anesthesiologist to patient communication: a systematic review. JAMA Netw Open. 2020;3(11):e2023503. doi: 10.1001/jamanetworkopen.2020.23503
  14. Afulani PA, Kelly AM, Buback L, et al. Providers’ perceptions of disrespect and abuse during childbirth: a mixed-methods study in Kenya. Health Policy Plan. 2020;35(5):577–586. doi: 10.1093/heapol/czaa009
  15. Vedam S, Stoll K, Taiwo TK, et al. The Giving Voice to Mothers study: inequity and mistreatment during pregnancy and childbirth in the United States. Reprod Health. 2019;16(1):77. doi: 10.1186/s12978-019-0729-2
  16. Sharma G, Penn-Kekana L, Halder K, Filippi V. An investigation into mistreatment of women during labour and childbirth in maternity care facilities in Uttar Pradesh, India: a mixed methods study. Reprod Health. 2019;16(1):7. doi: 10.1186/s12978-019-0668-y
  17. Camacho Avila M, Fernandez Medina IM, Jimenez-Lopez FR, et al. Parents’ Experiences About Support Following Stillbirth and Neonatal Death. Adv Neonatal Care. 2020;20(2):151–160. doi: 10.1097/ANC.0000000000000703
  18. Bohren MA, Tunçalp Ö, Miller S. Transforming intrapartum care: Respectful maternity care. Best Pract Res Clin Obstet Gynaecol. 2020;67:113–126. doi: 10.1016/j.bpobgyn.2020.02.005

Supplementary files

Supplementary Files
1. Fig. 1. Women’s satisfaction with the quality of psychological care provided at the hospital stage, abs. (%).

Download (63KB)
2. Fig. 2. A source of psychological assistance to patients with stillbirth.

Download (74KB)
3. Fig. 3. Realization of the patient’s preferences regarding her stay in consciousness at the time of delivery of a dead fetus.

Download (82KB)

Copyright (c) 2022 Eco-Vector

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies