• Ingela Rådestad, Pamela J Surkan, Gunnar Steineck, Sven Cnattingius, Erik Onelöv, and Paul W Dickman.
• Department of Caring Sciences and Public Health, Mälardalen University, Drottninggatan 16A, Eskilstuna, Sweden. Ingela.radestad@mdh.se
• Midwifery. 2009 Aug 1; 25 (4): 422-9.

Objectivesto investigate long-term outcomes of mothers who have or have not held their stillborn baby, and predictors of having held the baby.Designpostal questionnaires.Settinga nation-wide cohort study of mothers who gave birth to a singleton stillborn baby in Sweden in 1991.Participants314 out of 380 women answered the questionnaire and 309 reported whether or not they had held their baby.Measurementsscales measuring anxiety, depression and well-being.Findings126 (68%) mothers of 185 babies stillborn after 37 gestational weeks had held their baby and 82 (68%) mothers of 120 babies stillborn at gestational weeks 28-37 had also done so. Compared with mothers who agreed completely with the statement that staff gave enough support to hold the baby, mothers who did not agree were less likely to have held their baby [relative risk (RR) 4.1; 95% confidence interval (CI) 2.7-6.1], and mothers with a low level of education were less likely to have held their baby than mothers with a higher level of education (RR 2.2; 95% CI 1.3-3.8). Mothers who had not held their babies born after 37 gestational weeks had an increased risk of headache (RR 4.3; 95% CI 1.1-16.5), and they were less satisfied with their sleep (RR 2.7; 95% CI 1.5-5.0). The increased risk of long-term outcomes associated with not holding, compared with holding, a stillborn baby were less pronounced for women who gave birth at gestational week 28-37 compared with women who gave birth after 37 gestational weeks.Key Conclusionsin this cohort, we found an overall beneficial effect of having held a stillborn baby born after 37 gestational weeks, whereas findings for having held a stillborn baby born at gestational weeks 28-37 are uncertain. The attitude of staff influenced whether or not the mother held her stillborn baby.Implications For Practiceif the mother is guided by staff in a sensitive way to hold her stillborn term baby, the experience will possibly be beneficial for her in the long term.

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