Parents' experiences of care and support after stillbirth in rural and urban maternity facilities: a qualitative study in Kenya and Uganda
Mills, T.A.; Ayebare, E.; Mukhwana, R.; Mweteise, J.; Nabisere, A.; Nendela, A.; Ndungu, P.; Okello, M.; Omoni, G.; Wakasiaka, S.; Wood, R.; Lavender, T.
Bjog An International Journal of Obstetrics and Gynaecology 128(1): 101-109
2021
ISSN/ISBN: 1471-0528 PMID: 32659031 DOI: 10.1111/1471-0528.16413Document Number: 553954
To explore parents' lived experiences of care and support following stillbirth in urban and rural health facilities. Qualitative, interpretative, guided by Heideggerian phenomenology. Nairobi and Western Kenya, Kampala and Central Uganda. 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. In-depth interviews, analysed using Van Manen's reflexive approach. 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. 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. Health-system response and community support for parents after stillbirth in Kenya and Uganda are inadequate.