Caring for parents in a subsequent pregnancy after stillbirth: Availability of services across Australia and a social return on investment analysis

Pregnancy following stillbirth or neonatal death is a daunting prospect for many parents who have previously experienced the death of their baby. Standard antenatal care is unlikely to meet the emotional and medical needs of parents.1-3 Parents who have experienced the tragedy of stillbirth are five times more likely to have a stillborn baby in their next pregnancy, and are at increased risk for other adverse pregnancy outcomes such as pre-term birth.4 Parents also experience conflicted emotions, intense anxiety, fear, and other mental health difficulties such as depression. Yet this group remain under-represented in research and knowledge.

This project aims to gain a better understanding of the maternity care services available in Australia to parents during a subsequent pregnancy and to hear and listen to parents about what aspects of care are most important to them. This study will conduct two national online surveys: (1) maternity services: to identify models of care available to parents in a subsequent pregnancy; and (2) parents: to explore the elements of subsequent pregnancy care that were positive and negative to their experience. We will also conduct a social return on investment analysis (SROI) to determine the social value of providing specialised care to parents during a subsequent pregnancy. Rather than simply focusing on cost savings, this social value methodology takes account of the full range of impacts that matter to stakeholders. This study will be based on previous research conducted by Investigator Heazell and colleagues which has led to the implementation of 25 Rainbow Clinic services across the UK. These services provide specialised care to parents and families in subsequent pregnancies following stillbirth or neonatal death.