Psychosocial implications of stillbirth for the mother and her family : a crisis-support approach

[摘要] ENGLISH ABSTRACT: According to South African annual statistics, stillbirth is a relevant issue and National health policies, social welfare services and health care providers should place special focus on pregnant women to avoid the possible occurrence of a negative pregnancy outcome such as a stillbirth.An event that should have been a joyous birth, ended in a tragic death, forcing the mother to deal with the emotions of birth and death simultaneously. The bereaved mother needs to receive special care and support as soon as possible and the crisis intervention approach is seen as being helpful to regain a sense of equilibrium in her and the family's life before starting to adapt to the new situation.This study explores and describes the lived experience of 25 mothers who experienced a stillbirth. Focus was given to the psychosocial implications of stillbirth on mothers and their families. This study examined the mothers' feelings about the stillbirth six months or longer after the event, as well as its impact on relationships with partners and other children. By adopting a crisis intervention approach, the effectiveness of crisis intervention shortly after the stillbirth could be investigated.This study used a combination of quantitative and qualitative research approaches and assumed an exploratory and descriptive research design to provide a detailed description of the phenomenon being studied, i.e. the psychosocial implications of stillbirth. A questionnaire was used to obtain demographic (quantitative) data and a semi-structured questionnaire – the design based on information from literature - was administered during individual interviews. Obtained data was both measurable and rich in description and revealed that mothers still longed for their stillborn babies after a period of six or more months had passed. It also indicated that the father or partner of the baby and other children were affected by a stillbirth. Gender differences in how stillbirth is experienced by each partner, consequently adds extra tension on the relationship.Most of the mothers experienced the stillbirth as a crisis and found support in their mothers, family and a counsellor. Significantly, mothers felt crisis-intervention was beneficial, but preferred that crisis intervention be followed by on-going therapy. The stillbirth also resulted in feelings of alienation from community, friends and family - who did not know how to approach them. Generally, mothers were satisfied with medical care received but several issues regarding autopsy consent and guilt feelings surrounding this are highlighted.Important recommendations resulting from the study indicate that the crisis-intervention approach as method in social work is effective when rendering service for bereaved mothers and families after a stillbirth. It helps to regain a sense of equilibrium, but further intervention is recommended to facilitate the grief process. In addition, the study emphasizes the importance of social workers being aware that the stillbirth causes tension in partner- and family relationships. Receiving social work intervention is not only highly effective, but allows bereaved mothers to feel empowered and encouraged to openly grieve for their stillborn babies - much needed in an environment where a stillbirth is seen as a silent birth.

[发布机构] Stellenbosch University