The prevention of psychological morbidity following perinatal death.

In recent years, a significant volume of hospital-based literature has been produced about the management of women and their families after a perinatal death. There has also been a considerable amount of work in the voluntary sector which has recognized this as an area of unmet need. The introduction of regional neonatal intensive care units and the shift from secondary to primary care make the development of a structured community-based approach for this group of vulnerable patients increasingly important. This article documents the evidence for high levels of psychological morbidity following perinatal death, reviews a variety of interventions designed to reduce morbidity, and makes some tentative proposals about the key elements of an effective community-based support programme.