Abstract
ObjectiveTo explore the experiences and perceptions of stillbirth among mothers from a tertiary medical centre in Kano, Northern Nigeria.DesignQualitative, interpretative.SettingTertiary healthcare facility, Murtala Muhammad Specialist Hospital (MMSH), Kano, Northern Nigeria.SampleMothers who had given birth to a liveborn baby at the MMSH in the prior 6 months (n = 31). In order to capture the experiences and perception of stillbirth within this cohort we approached mothers who had in a previous pregnancy experienced a stillbirth. Of the 31 who attended 16 had a previous stillbirth.MethodsSemi-structured Focus Group Discussions, consisting of open-ended questions about stillbirth, beliefs, experiences and influences were held in MMSH, conducted over 1 day.ResultsOur findings highlight that this is a resource-poor tertiary facility serving an ever-growing population, increasing strain on the hospital and healthcare workers. Many of the participants highlighted needing permission from certain family members before accessing healthcare or medical treatment. We identified that mothers generally have knowledge on self-care during pregnancy, yet certain societal factors prevented that from being their priority. Judgement and blame was a common theme, yet a complex area entwined with traditions, superstitions and the pressure to procreate with many mothers described being made to feel useless and worthless if they did not birth a live baby.ConclusionsAs access to healthcare becomes easier, there are certain traditions, family and social dynamics and beliefs which conflict with scientific knowledge and act as a major barrier to uptake of healthcare services. The findings highlight the need for investment in maternity care, appropriate health education and public enlightenment; they will help inform appropriate interventions aimed at reducing stigma around stillbirth and aide in educating mothers about the importance of appropriate health seeking behaviour. Stillbirths are occurring in this area of the world unnecessarily, globally there has been extensive research conducted on stillbirth prevention. This research has highlighted some of the areas which can be tackled by modifying existing successful interventions to work towards reducing preventable stillbirths.
Highlights
Mothers in Sub-Saharan Africa (SSA) and South Asia bear the greatest burden of stillbirth
We identified that mothers generally have knowledge on self-care during pregnancy, yet certain societal factors prevented that from being their priority
The findings highlight the need for investment in maternity care, appropriate health education and public enlightenment; they will help inform appropriate interventions aimed at reducing stigma around stillbirth and aide in educating mothers about the importance of appropriate health seeking behaviour
Summary
Mothers in Sub-Saharan Africa (SSA) and South Asia bear the greatest burden of stillbirth. In 2019, over 75% of estimated global stillbirths occurred across these two continents: 44% in SSA and 33% in South Asia [1]. 98%, of the world’s stillbirths occur in low- and middle-income countries (LMICs) and it is reported that Nigeria accounts for 12% (n = 312,000) of those [2]. The neonatal mortality rate in Nigeria is 35.9/1000 live births, placing it as the sixth largest contributor to neonatal mortality after, Lesotho, Pakistan, South Sudan, Somalia and Afghanistan; predominantly countries experiencing severe conflict [5]. Stillbirth rates are more challenging to quantify and vary depending on data source. There are many reasons for the reported disparity including varying definitions of stillbirth, unreliable reporting systems, homebirths or unrecorded healthcare professional monitoring. It is reasonable to assume that the reported rates are an underestimation [6]
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