Joining-up thinking: Loss in childbearing from inter-disciplinary perspectives

Kok, Bregje de; Hussein, Julia; Jeffery, Patricia

doi:10.1016/j.socscimed.2010.08.021

Cited by 13 publications

(3 citation statements)

References 32 publications

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“…The design of contextualized studies of why loss in childbearing is still a serious public health problem has recently been encouraged by “joining-up thinking” from multi-disciplinary perspectives [10]. The “thinking” highlights the importance of non-medical factors that may play a determinant role in understanding healthcare-seeking behaviors such as the gender aspects of decision-making and local perceptions of illness and treatment [11-16].…”

Section: Introductionmentioning

confidence: 99%

Shaping healthcare-seeking processes during fatal illness in resource-poor settings. A study in Lao PDR

Alvesson

Lindelöw²,

Khanthaphat³

et al. 2012

BMC Health Serv Res

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BackgroundThere are profound social meanings attached to bearing children that affect the experience of losing a child, which is akin to the loss of a mother in the household. The objective of this study is to comprehend the broader processes that shape household healthcare-seeking during fatal illness episodes or reproductive health emergencies in resource-poor communities.MethodsThe study was conducted in six purposively selected poor, rural communities in Lao PDR, located in two districts that represent communities with different access to health facilities and contain diverse ethnic groups. Households having experienced fatal cases were first identified in focus group discussions with community members, which lead to the identification of 26 deaths in eleven households through caregiver and spouse interviews. The interviews used an open-ended anthropological approach and followed a three-delay framework. Interpretive description was used in the data analysis.ResultsThe healthcare-seeking behavior reported by caregivers revealed a broad range of providers, reflecting the mix of public, private, informal and traditional health services in Lao PDR. Most caregivers had experienced multiple constraints in healthcare-seeking prior to death. Decisions regarding care-seeking were characterized as social rather than individual actions. They were constrained by medical costs, low expectations of recovery and worries about normative expectations from healthcare workers on how patients and caregivers should behave at health facilities to qualify for treatment. Caregivers raised the difficulties in determining the severity of the state of the child/mother. Delays in reaching care related to lack of physical access and to risks associated with taking a sick family member out of the local community. Delays in receiving care were affected by the perceived low quality of care provided at the health facilities.ConclusionsCare-seeking is influenced by family- and community-based relations, which are integrated parts of people’s everyday life. The medical and normative responses from health providers affect the behavior of care-seekers. An anthropological approach to capture the experience of caregivers in relation to deciding, seeking and reaching care reveals the complexity and socio-cultural context surrounding maternal and child mortality and has implications for how future mortality data should be developed and interpreted.

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Section: Introductionmentioning

confidence: 99%

Shaping healthcare-seeking processes during fatal illness in resource-poor settings. A study in Lao PDR

Alvesson

Lindelöw²,

Khanthaphat³

et al. 2012

BMC Health Serv Res

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“…In general, perinatal deaths are common in SAMM, and in our original sample of 81 episodes of (pre-) eclampsia the perinatal death rate was 30% (Mooij et al 2015). This means long-term effects after SAMM arise not only due to persistent maternal illness but also because of the perinatal loss in childbearing (de Kok et al 2010;Mooij et al 2021).…”

Section: Discussionmentioning

confidence: 87%

“…There is also a need to study how couples make family planning decisions after SAMM, and to what extent these decisions are shared. Women's social status within the household may diminish after SAMM, especially in case of perinatal loss (de Kok et al 2010;Storeng et al 2010), and this may further compromise her already limited reproductive health decision-making power. More studies are needed as well to evaluate strategies for involving men and increasing complication readiness and birth preparedness.…”

Section: Discussionmentioning

confidence: 99%

Role of male partners in the long-term well-being of women who have experienced severe pre-eclampsia and eclampsia in rural Tanzania: a qualitative study

Mooij

Kapanga

Mwampagatwa

et al. 2021

Journal of Obstetrics and Gynaecology

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Men can be essential sources of support in maternal health, even more so in case of severe acute maternal morbidity (SAMM), affecting 1-2% of childbearing women in low-resource settings. In a qualitative study using semi-structured interviews, we explored the perspectives of nine male partners of women who suffered from (pre-)eclampsia six to seven years earlier in rural Tanzania. Male partners considered their role to be pivotal regarding finances, decision-making in healthcare-seeking and family planning and provided physical and emotional support. After SAMM, households may be affected in the long run. Some men took over their female partner's household duties until up to two years after birth. Providing men with more information on complication readiness and birth preparedness would enable them to extend their role in maternal morbidity prevention. IMPACT STATEMENTWhat is already known on this subject? The essential role of male partners in maternal health in low-and middle-income countries is well-studied in relation to its impact on care-seeking behaviour. After childbirth, the long-term role of male partners has not yet been studied. What do the results of this study add? We demonstrated the important role of men during, but also after SAMM. Households may be affected years after women suffered from SAMM. For women with the most urgent support needs, this study suggest that at least some men feel responsible for their partner and have different pivotal roles. What are the implications of these findings for clinical practice and/or further research? Because of their motivation to support their female partner, strategies to reduce recurring complications in subsequent pregnancies should include targeting male partners, for example, by increasing birth preparedness and complication readiness. Further studies should confirm the results from our innovative but small-scale study, as well as investigate the long-term role of male partners after uncomplicated births. Other studies could investigate the separation of couples after SAMM, family planning decisions after SAMM and strategies for involving men and increasing complication readiness and birth preparedness.

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Miscarriage

2012

Reproductive Health Psychology

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Joining-up thinking: Loss in childbearing from inter-disciplinary perspectives

Cited by 13 publications

References 32 publications

Shaping healthcare-seeking processes during fatal illness in resource-poor settings. A study in Lao PDR

Shaping healthcare-seeking processes during fatal illness in resource-poor settings. A study in Lao PDR

Role of male partners in the long-term well-being of women who have experienced severe pre-eclampsia and eclampsia in rural Tanzania: a qualitative study

Miscarriage

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