P2.F120: Pilot Study of a Referral Program for Hospitalized Bereaved Parents Following Perinatal Death

Background: Perinatal deaths affect approximately 37,000 families in the United States annually. Following a perinatal death, parents and families may experience biological, psychological, social morbidity. Supporting parents and families following perinatal death should occur at the time of death and after hospital discharge. Missing Pieces, a community-based organization, developed a program to help families find community bereavement and social support resources following perinatal loss. The program begins with hospital staff referring families to Missing Pieces. We assessed referral use (i.e., referrals from the hospital to Missing Pieces) and feasibility of obtaining parent input. We also describe characteristics of parents who experienced a perinatal death and their bereavement and social support resource use based on survey and interview responses.

Methods: This pilot study involved Prentice Women’s Hospital (PWH), an urban academic women’s hospital, and Missing Pieces. Social workers at PWH learned how to refer bereaved parents to Missing Pieces. English and Spanish-speaking mothers and their partners who experienced a perinatal death following delivery were eligible for referral. Once referred to Missing Pieces, a grief navigator contacted parents, assessed parents’ bereavement needs (e.g., support groups or therapists) and social support needs (e.g., housing or childcare), and provided parents with information about relevant community-based bereavement and social support resources. Mothers and their partners were invited to complete a survey and interview 6 months following their infant’s death. We assessed referral use by calculating the percentage of referred families and via interviews. We assessed feasibility of obtaining parent input by calculating survey and interview response rates. Surveys included demographics and validated tools measuring complicated grief and post-traumatic growth.

Results: Of 150 eligible families, 23% (35/150) were referred to Missing Pieces. 25% (38/150) of parents completed the survey, and of those 21% (8/38) completed an interview. Table 1 shows survey participant characteristics. Figure 1 shows the bereavement resources used by the families. 13% (5/38) of parents used no bereavement resources. 26% (10/38) of families used social support resources including assistance with: transportation (n=2, 5%); employment or financial issues (n=2, 5%); childcare (n=1, 3%); and funeral, burial, or cremation services (n=7, 18%). Three themes emerged from the interviews: 1) Recalling hospital events was hard leaving many unable to reflect on the referral process; 2) Positive attitudes about the bereavement resources used; and 3) Parents commonly obtained support from family and community members (e.g., friends, religious leaders).

Conclusion: Referral rates (only 23%) and qualitative input from parents suggest that referring families to Missing Pieces during the hospitalization after a perinatal loss is challenging. Similarly, recruiting families for participation in surveys after a perinatal death is challenging. Commonly used bereavement supports come from family, community, and counselors. Unmet resource needs exist for bereaved parents following perinatal death.