Obstetricians and gynaecologists working in Irish maternity hospitals should receive specialist training in how to care for parents who have been told that their baby has died in the womb or will die before birth.

According to a new study carried out in Cork University Maternity Hospital (CUMH), while consultants working in this field had a high level of awareness of the devastating impact a stillbirth can have, none had received any specialist training in perinatal bereavement care.

Instead, all of them learned ‘on the job' and from senior colleagues during their training.

"The diagnosis that a baby will not survive or has already died in utero brings with it a bewildering array of emotional distress, where birth and death collide with life-long impact for the parents. How parents are cared for during this delicate time can have long-lasting consequences, both positive and negative," the researchers said.

They set out to assess the experiences of consultant obstetricians who were caring for parents who had been given the devastating news that their baby had already died or would die before birth.

Not surprisingly, the consultants said that dealing with stillbirths is one of the most difficult parts of their job. Feelings of sadness, anger, fear and remorse were common. However, a lack of support structures to discuss the effects of such an event was evident.

The researchers said that the human and professional impact of stillbirth on consultants needs to be acknowledged. This is important if a more supportive environment is to be created and it could reduce the risk of stress, burnout and compassion fatigue among these doctors.

Specialist ongoing training in perinatal bereavement care should also be provided to these specialists.

Following on from this study, a course on bereavement training is to take place at CUMH.

"Following our study, we recommend that consultants are encouraged to avail of existing professional and personal support structures, and that the importance of support and self-care are included in medical curricula and continuing professional development," commented the study's main author, Dr Daniel Nuzum.

He added that this study ‘represents both an invitation and a challenge to consultants and to health service managers to acknowledge the clinicians' burden of loss and to manage what are sometimes unrealistic expectations'.

Details of these findings are published in BJOG: An International Journal of Obstetrics and Gynaecology.

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