What are the key considerations for discussing the implications of stillbirth with parents during the initial consultation?

When discussing the implications of stillbirth with parents during the initial consultation, healthcare professionals must prioritise sensitive communication and comprehensive support. It is crucial to treat all women with dignity and respect, acknowledging that individuals will react to the loss of a pregnancy in different ways NICE NG126. Healthcare professionals should offer support to help women and their partners and family cope with the emotional and physical consequences of the death, and provide information about specialist support NICE NG207. Training in sensitive communication and breaking bad news is essential for healthcare professionals providing care in these circumstances, as early pregnancy complications can cause significant distress NICE NG126. Non-clinical staff should also receive training on sensitive communication NICE NG126.

Regarding information giving and shared decision-making, specific evidence-based information should be provided in a variety of formats to the woman and, with her consent, her partner NICE NG126. Information should be delivered using clear language, tailored to the woman's needs and preferences, and offered face-to-face, supplemented by virtual discussions and written formats NICE NG194. It must be individualised, sensitive, supportive, respectful, evidence-based, and consistent, with appropriate translation if needed NICE NG194. Healthcare professionals should check that the woman understands the information and provide regular opportunities for her to ask questions, allocating sufficient time for discussion NICE NG194.

Involving partners is also a key consideration; partners should be involved according to the woman's wishes NICE NG194. Those with parental responsibility have the right to be involved in the baby's care if they choose NICE NG194.

For the medical management, if the woman appears physically well, her membranes are intact, and there is no evidence of infection or bleeding, healthcare professionals should discuss the options for birth, which include expectant management, induction of labour, or caesarean birth, and respect the woman's decision NICE NG207. However, if there is evidence of ruptured membranes, infection, or bleeding, immediate induction of labour or caesarean birth should be offered NICE NG207. For women who have had a previous caesarean birth, methods of induction should be discussed to enable an informed decision about the most appropriate choice NICE NG207.