Abstract
BackgroundIn developed countries, perinatal death is known to cause major emotional and social effects on mothers. However, little is known about these effects in low income countries which bear the brunt of perinatal mortality burden. This paper reports the impact of perinatal death on psychological status and social consequences among mothers in a rural area of Bangladesh.MethodsA total of 476 women including 122 women with perinatal deaths were assessed with the Edinburgh Postnatal Depression Scale (EPDS-B) at 6 weeks and 6 months postpartum, and followed up for negative social consequences at 6 months postpartum. Trained female interviewers carried out structured interviews at women's home.ResultsOverall 43% (95% CI: 33.7-51.8%) of women with a perinatal loss at 6 weeks postpartum were depressed compared to 17% (95% CI: 13.7-21.9%) with healthy babies (p = < 0.001). Depression status were significantly associated with women reporting negative life changes such as worse relationships with their husband (adjusted OR = 3.89, 95% CI: 1.37-11.04) and feeling guilty (adjusted OR = 2.61, 95% CI: 1.22-5.63) following the results of their last pregnancy outcome after 6 months of childbirth.ConclusionsThis study highlights the greatly increased vulnerability of women with perinatal death to experience negative psychological and social consequences. There is an urgent need to develop appropriate mental health care services for mothers with perinatal deaths in Bangladesh, including interventions to develop positive family support.
Highlights
In developed countries, perinatal death is known to cause major emotional and social effects on mothers
The results indicate that such women experience increased rates of depression at 6 weeks postpartum and suffer from negative social consequences that persist 6 months after the perinatal death
This study found significantly higher levels of depressive symptoms in women with perinatal loss compared to non-bereaved mothers at 6 weeks postpartum
Summary
Perinatal death is known to cause major emotional and social effects on mothers. Little is known about these effects in low income countries which bear the brunt of perinatal mortality burden. This paper reports the impact of perinatal death on psychological status and social consequences among mothers in a rural area of Bangladesh. Perinatal mortality can have a major emotional impact on members of the affected. Mothers who have lost their babies either by stillbirth or neonatal death are 7-9 times more likely to suffer from depression than women with a live baby [6]. A 30 month follow up study on bereaved mothers noted a substantial reduction in the incidence of distress over the study period, from 21% at 2 months, 14% at 8 months to 10% at 30 months [8].
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