Parents’ experiences of care and support after stillbirth in rural and urban maternity facilities: A qualitative study in Kenya and Uganda

Tracey A Mills, Elizabeth Ayebare, Raheli Mukhwana, Jonan Mweteise, Allen Nabisere, Anne Nendela, Paul Ndungu, Marion Okello, Grace Omoni, Sabina Wakasiaka, Rebecca Wood, Tina Lavender

Research output: Contribution to journalArticlepeer-review

Abstract

Objective
To explore parents' lived experiences of care and support following stillbirth in urban and rural health facilities.

Design
Qualitative, interpretative, guided by Heideggerian phenomenology.

Setting
Nairobi and Western Kenya, Kampala and Central Uganda.

Sample
A purposive sample of 75 women and 59 men who had experienced the stillbirth of their baby (≤1 year previously) and received care in the included facilities.

Methods
In‐depth interviews, analysed using Van Manen's reflexive approach.

Results
Three main themes were identified; parents described devastating impacts and profound responses to their baby's death. Interactions with health workers were a key influence, but poor communication, environmental barriers and unsupportive facility policies/practices meant that needs were often unmet. After discharge, women and partners sought support in communities to help them cope with the death of their baby but frequently encountered stigma engendering feelings of blame and increasing isolation.

Conclusions
Parents in Kenya and Uganda were not always treated with compassion and lacked the care or support they needed after the death of their baby. Health workers in Kenya and Uganda, in common with other settings, have a key role in supporting bereaved parents. There is an urgent need for context and culturally appropriate interventions to improve communication, health system and community support for African parents.
Original languageEnglish
JournalBJOG: An International Journal of Obstetrics & Gynaecology
Early online date13 Jul 2020
DOIs
Publication statusE-pub ahead of print - 13 Jul 2020

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