Worksheet helps in poststillbirth counseling: decision support document has a question-and-answer format, addresses concerns of grieving parents.(Obstetrics)

BOSTON -- There are several ways physicians can offer support to parents after a fetal death, Ruth C. Fretts, M.D., said at a meeting cosponsored by Harvard Medical School and Brigham and Women's Hospital.

She offered several suggestions on how to counsel parents after a stillbirth, including use of a decision support worksheet and a kind of parental bill of rights. (See box.)

The worksheet takes a question-and-answer format and provides space for parents to list their own thoughts and questions. Although answers to the questions may vary by hospital, the questions address general concerns of grieving parents.

The worksheet was originally designed by a social worker in Chicago who had a stillbirth. "When a bad thing happens, all hell breaks loose. It's hard to even think. This is a checklist for the patient to hold, to look at, and to go through. When your mind is thinking of all of these millions of things, it's helpful for the patient, and it's helpful for the providers. And it has a thoughtful approach to the value of an autopsy," said Dr. Fretts, assistant professor of obstetrics and gynecology, Harvard Medical School, Boston.

Some questions included on the worksheet:

* What are my options for burial or cremation?

* Should we see and/or hold our baby?