Parental Perceptions of Counseling Regarding Interpregnancy Interval After Stillbirth or Neonatal Death

Objective: Although guidelines exist regarding optimal IPI after live birth, both optimal IPI and counseling regarding recommended IPI (rIPI) after stillbirth or neonatal death is not well established. Our goal was to describe the counseling bereaved parents receive regarding IPI, parents' reactions to that counseling, and actual IPI after loss. Study Design: Bereaved parents who had a previous pregnancy result in stillbirth or neonatal death participated in a web-based survey. Questions included demographics, details of stillbirth or neonatal death, IPI counseling, and pregnancy after loss. Demographic information, rIPI, and actual IPI were reported using descriptive statistics. Wilcoxon rank sum test was used to test the association between recommended IPI and mode of delivery. Spearman's correlation was used to test the association between recommended IPI and maternal age. Results: 275 surveys were analyzed. Mean gestational age of stillbirth delivery was 33.1 (SD 6.6) weeks. 29% delivered via Cesarean. Median rIPI was 6 (interquartile ratio [IQR] 2-9) months, with the primary reason for IPI reported as the need to heal (74%). Delivery via cesarean was associated with longer rIPI, 9 vs 4.2 months (p<0.0001). Maternal age was not associated with rIPI. Of 144 people who pursued pregnancy again, median time until attempting conception was 3.5 (IQR 2-6) months. Median actual IPI was 6 (IQR 4-10) months. Conclusion: Bereaved parents receive a wide range of counseling regarding rIPI. The majority receive rIPI and pursue actual IPI shorter than current national and international recommendations for optimal IPI.