Grief and Women: Stillbirth in the Social Context of India

Abstract

INTRODUCTION Few in Western society would argue the potentially devastating impact of stillbirth related grief; but in many developing countries where stillbirth remains the highest in the world, perinatal grief is barely recognized as an issue. The purpose of this study was to explore how poor, rural central Indian women perceive and cope with stillbirths. METHODS Seventeen key informant interviews and two focus groups (N = 33) with local health care providers, family members, and women who experienced stillbirth were conducted over a 1-month period in 2011 and then systematically coded for emerging themes using grounded theory methods to explore how women experienced stillbirth. RESULTS Although usually never talked about and not recognized as an issue, perinatal grief emerged as a significant shared experience by all. The perceptions of stillbirth-related grief emerged in three major themes and bear evidence of gender and power issues and indicate that local social norms negatively factor heavily into their perinatal grief experiences. DISCUSSION The findings in this richly textured study add to the limited literature regarding rural, central Indian women's experiences with stillbirth and factors influencing their resulting perinatal grief. In light of the void of recognition of this phenomenon in Indian society, a better understanding of the context in which poor Indian women experience perinatal grief will be a first step toward developing much needed culturally rooted interventions to positively impact the women's abilities to better cope with stillbirth in the context of their realities.

India's Distorted Sex Ratio

“…In previous ethnographic work, social norms and expectations such as early marriage and subsequent childbearing within the first year; strong son preference that jeopardizes the well-being of women who fail to produce sons; and young mothers with little or no say as to who will attend the birth, where her baby is delivered, or how many children to have (Roberts, Anderson, Lee, & Montgomery, 2012) were emerging themes influencing fertility patterns. Therefore, these factors informed the selection of variables in the current data abstraction.…”

Autonomy and Social Norms in a Three Factor Grief Model Predicting Perinatal Grief in India

“…These data were gathered from a cohort of 355 poor, rural women of central India (see Table 1) as part of a larger mixed-methods study exploring women's perceptions of stillbirth and factors that inhibit or enhance coping with perinatal grief (Roberts et al, 2012a;Roberts et al, 2012b). Structured interviews were used to collect demographics as well as measure acceptance of social norms pertaining to expectations of women's response to stillbirth, perceived social provision of support, intrinsic religiosity, coping methods, autonomy, and perinatal grief.…”

“…Perinatal grief following stillbirth is a significant social and mental health burden. Therefore, in India, where stillbirth rates are high, perinatal grief affects the day-to-day life of many women (Roberts, Anderson, Lee, & Montgomery, 2012a;Roberts, Montgomery, Lee, & Anderson, 2012b).…”

The Association of Women’s Empowerment with Stillbirths in Nepal

“…World Health Organization (WHO) defines stillbirths as no signs of life in babies at or after 28 weeks of gestation (World Health Organization 2014). Most stillbirths in LMICs are intrapartum and cause profound damage and grief (Roberts et al 2012). In South Asia, 59% of stillbirths occur in the intrapartum period (Lawn et al 2016).…”

“…Stillbirths cause many women significant distress, potentially resulting in mental health issues (Roberts et al 2012). In some societies, having a stillbirth can lead to abuse and even abandonment by husbands (Kiguli et al 2016;Roberts et al 2012).…”