Social and Cultural Factors Associated with Perinatal Grief in Chhattisgarh, India

Abstract

Stillbirth is a globally significant public health problem with many medical causes. There are also indirect causal pathways including social and cultural factors which are particularly salient in India's traditional society. The purpose of this study was to explore women's perceptions of stillbirth and to determine how issues of gender and power, social support, coping efforts, and religious beliefs influence perinatal grief outcomes among poor women in rural Chhattisgarh, India. Structured interviews were done face-to-face in 21 randomly selected villages among women of reproductive age (N = 355) who had experienced stillbirth (n = 178) and compared to those who had not (n = 177), in the Christian Hospital, Mungeli catchment area. Perinatal grief was significantly higher among women with a history of stillbirth. Greater perinatal grief was associated with lack of support, maternal agreement with social norms, and younger maternal age. These predictors must be understood in light of an additional finding—distorted sex ratios, which reflect gender discrimination in the context of Indian society. The findings of this study will allow the development of a culturally appropriate health education program which should be designed to increase social support and address social norms, thereby reducing psychological distress to prevent complicated perinatal grief. Perinatal grief is a significant social burden which impacts the health women.

Taiwanese Women's Process of Recovery From Stillbirth: A Qualitative Descriptive Study

“…Social and cultural differences influence how women perceive, grieve, and cope with stillbirth (Roberts, Montgomery, Lee, & Anderson, 2012). Even within an ostensibly homogeneous population, there are significant variations (Shaefer, 2010).…”

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

“…Our hypothesis was that women with increased autonomy would be less isolated and have greater opportunity for fulfillment through means other than fertility. Additionally, we hypothesized that those with more autonomy would be less accepting of traditional social norms and possibly have a wider network of social support-both of which were found to have a protective effect in terms of perinatal grief outcomes in our previous study (Roberts et al, 2012b). It is possible that the reason autonomy, instead, was associated with increased acute grief in this context is that with greater autonomy there is some freedom of choice, which may make it harder to simply accept the stillbirth as one's fate.…”

“…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.…”

“…While the Indian medical society has not traditionally acknowledged perinatal grief as a significant problem (Mehta & Verma, 1990), more recent studies have shown that perinatal grief is not a Western phenomenon (Mammen, 1995) and perinatal grief is indeed a significant problem and social burden in India (Roberts et al, 2012b) that can negatively impact women's health.…”

“…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).…”