Abstract
BackgroundStillbirth is an extremely traumatic and distressing experience for parents, with profound and long-lasting negative impacts. Cultural beliefs and practices surrounding death vary considerably across different contexts and groups, and are a key influence on individual experiences, impacting grief, adjustment, and support needs. Few studies have explored cultural influences surrounding stillbirth in an African context. This study explored the influence of cultural beliefs and practices on the experiences of bereaved parents and health workers after stillbirth in urban and rural settings in Kenya and Uganda.MethodsA qualitative descriptive study design was employed. Face to face interviews were conducted with parents (N = 134) who experienced a stillbirth (≤ 1 year) and health workers (N = 61) at five facilities in Uganda and Kenya. Interviews were conducted in English or the participants’ local language, audio-recorded and transcribed verbatim. Analysis was conducted using descriptive thematic analysis.ResultsCommonalities in cultural beliefs and practices existed across the two countries. Three main themes were identified: 1) Gathering round, describes the collective support parents received from family and friends after stillbirth. 2)‘It is against our custom’ addresses cultural constraints and prohibitions impacting parents’ behaviour and coping in the immediate aftermath of the baby’s death. 3) ‘Maybe it’s God’s plan or witchcraft’ summarises spiritual, supernatural, and social beliefs surrounding the causes of stillbirth.ConclusionsKinship and social support helped parents to cope with the loss and grief. However, other practices and beliefs surrounding stillbirth were sometimes a source of stress, fear, stigma and anxiety especially to the women. Conforming to cultural practices meant that parents were prevented from: holding and seeing their baby, openly discussing the death, memory-making and attending the burial. The conflict between addressing their own needs and complying with community norms hindered parents’ grief and adjustment. There is an urgent need to develop culturally sensitive community programmes geared towards demystifying stillbirths and providing an avenue for parents to grieve in their own way.
Highlights
Stillbirth is an extremely traumatic and distressing experience for parents, with profound and longlasting negative impacts
Culture, which is often defined as patterns of learned and shared behaviours and values evolving over generations within communities [5], is a key influence on acceptable conduct within societies
The research teams were supported by Community Engagement and Involvement (CEI) groups of parents who had previously experienced the death of a baby, and stakeholder groups including local academics, clinicians, and policy makers
Summary
Stillbirth is an extremely traumatic and distressing experience for parents, with profound and longlasting negative impacts. The death of a baby before or during childbirth is a traumatic and distressing experience for parents and families [3] associated with wide ranging and long-lasting negative health and social impacts. Research surrounding the impact of stillbirth, mostly conducted in high-income countries (HICs), demonstrates that the death of a baby, before or during birth is a unique experience, associated with significant social stigma and isolation. This can invalidate parent’s grief experiences, prolonging and intensifying negative emotions. Lack of awareness and understanding amongst families and communities combine to reduce social support, which is recognised as a critical predictor of effective coping and adjustment [9]
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