Understanding the complexities of unexplained stillbirth in sub‐Saharan Africa: a mixed‐methods study

Objective To understand the complexities surrounding unexplained stillbirth for the development and implementation of culturally acceptable interventions to underpin care in Tanzania and Zambia. Design Mixed‐methods study. Setting Tertiary, secondary and primary care facilities in Mansa, Zambia, and...

Full description

Saved in:

Bibliographic Details
Published in:	BJOG : an international journal of obstetrics and gynaecology Vol. 128; no. 7; pp. 1206 - 1214
Main Authors:	Bedwell, C, Blaikie, K, Actis Danna, V, Sutton, C, Laisser, R, Tembo Kasengele, C, Wakasiaka, S, Victor, S, Lavender, T
Format:	Journal Article
Language:	English
Published:	England Wiley Subscription Services, Inc 01-06-2021 John Wiley and Sons Inc
Subjects:	Adolescent Adult Autopsies Autopsy Cause of Death Communication Counseling Empathy Female Grief Grounded Theory Health risks Humans Medical personnel Mixed methods research mixed‐methods study Nurse patient relationships Original Parents & parenting Perinatal care Physician patient relationships Pregnancy Pregnancy complications Primary care Professional-Family Relations Quality of care Stillbirth Stillbirth - epidemiology Stillbirth - psychology sub‐Saharan Africa Tanzania - epidemiology Training Young Adult Zambia - epidemiology Zambia Tanzania Sub-Saharan Africa stillbirth mixed-methods study sub-Saharan Africa communication Autopsy grief
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Objective To understand the complexities surrounding unexplained stillbirth for the development and implementation of culturally acceptable interventions to underpin care in Tanzania and Zambia. Design Mixed‐methods study. Setting Tertiary, secondary and primary care facilities in Mansa, Zambia, and Mwanza, Tanzania. Sample Quantitative: 1997 women giving birth at two tertiary care facilities (one in each country). Qualitative: 48 women and 19 partners from tertiary, secondary and primary care facilities. Methods Case review using data from a target of 2000 consecutive case records. Qualitative interviews with a purposive sample of women and partners, using a grounded theory approach. Results A total of 261 stillbirths were recorded, with a rate of 16% in Tanzania and 10% in Zambia, which is higher than the previous estimates of 2.24 and 2.09%, respectively, for those countries. Women in both countries who reported a previous stillbirth were more likely to have stillbirth (RR 1.86, 95% CI 1.23–2.81). The cause of death was unexplained in 28% of cases. Qualitative findings indicated that not knowing what caused the baby to be stillborn prevented women from grieving. This was compounded by the poor communication skills of health professionals, who displayed little empathy and skill when counselling bereaved families. Conclusions The stillbirth risk in both facilities was far higher than the risk recorded from national data, with women reporting a previous stillbirth being at higher risk. Women want to know the cause of stillbirth and an exploration of appropriate investigations in this setting is required. Providing health professionals with support and continuing training is key to improving the experiences of women and future care. Tweetable Stillbirths receive little investigation and are often unexplained. Communication with women about the death of their baby is limited. Tweetable Stillbirths receive little investigation and are often unexplained. Communication with women about the death of their baby is limited.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1470-0328 1471-0528
DOI:	10.1111/1471-0528.16629