Stage-based bereavement support for parents after stillbirth: an umbrella review

BACKGROUND: Stillbirth is a profound and often under-recognised form of perinatal loss that can result in enduring grief. Despite numerous interventions, there is limited synthesis of evidence across the grief trajectory. OBJECTIVE: This umbrella review synthesised evidence from systematic reviews to identify bereavement support strategies for parents after stillbirth, structured by stages of grief. METHODS: Six databases and grey literature were searched for qualitative, quantitative, or mixed-methods systematic reviews. Two reviewers independently conducted screening, critical appraisal (JBI tools), and data extraction. A thematic synthesis and corrected covered area matrix addressed overlapping data. RESULTS: Eleven reviews met the inclusion criteria. Strategies were mapped to three stages: (1) acute grief - empathetic presence, validation of loss, and immediate containment; (2) adjustment - relational support, memory-making, and peer-based programmes; and (3) long-term integration - structured follow-up, meaning-making, and anticipatory guidance for future pregnancies. Approaches differed in scope, intensity, and cultural framing. CONCLUSIONS: This review proposes a stage-based framework to inform interdisciplinary, grief-informed bereavement care. Synthesised strategies may enhance the emotional recovery and long-term adaptation of bereaved parents following stillbirth. REGISTRATION: PROSPERO: CRD420251035521 (registered 18 April 2025).