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‘I should have seen her face at least once’: parent’s and healthcare providers’ experiences and practices of care after stillbirth in Kabul province, Afghanistan

Journal of Perinatology volume 41, pages 2182–2195 (2021)Cite this article

Subjects

Abstract

Objective

This study aimed to explore bereaved parents’ and healthcare providers experiences of care after stillbirth.

Study design

Qualitative in-depth interviews with 55 women, men, female elders, healthcare providers and key informants in Kabul province, Afghanistan between October and November 2017.

Results

Inadequate and insensitive communication and practices by healthcare providers, including avoiding or delaying disclosing the stillbirth were recurring concerns. There was a disconnect between parents’ desires and healthcare provider’s perceptions. The absence of shared decision-making on seeing and holding the baby and memory-making, manifested as profound regret. Health providers’ reported hospitals were not equipped to separate women who had a stillbirth and acknowledged that psychological support would be beneficial. However, the absence of trained personnel and resource constraints prevented provision of such support.

Conclusion

Findings can inform future provision of perinatal bereavement care. Given resource constraints, communication training can be considered with longer term goals to develop context-appropriate bereavement care guidelines.

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Fig. 1: Themes and sub-themes related to perinatal bereavement care practices, perceptions and experiences among Afghan parents and healthcare providers in our study.

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Acknowledgements

We sincerely thank all study participants who gave their time to share their personal experiences and insights. Many thanks to our interviewers, Mr Rohullah Sahibzada, Ms Nasreen Quaraishi and Ms Friba Nasiri for their role in data collection. We are also grateful to the staff at participating health facilities that assisted in various ways during data collection. We would like to acknowledge the Ministry of Public Health and hospital managers for permitting access to the health facilities and Management Sciences for Health, Afghanistan, and their staff for supporting and facilitating data collection in Kabul.

Funding

This study was partly funded through the Sydney School of Public Health and Grants-in-Aid funds from the University of Sydney. While completing this work, AC was supported by an Australian Postgraduate Award received through the Australian Commonwealth Government and CRG was in receipt of a National Health and Medical Research Council Career Development Fellowship (1087062).

Author information

Authors and Affiliations

  1. Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia

    Aliki Christou, Ashraful Alam & Camille Raynes-Greenow

  2. Afghanistan National Public Health Institute, Ministry of Public Health, Kabul, Afghanistan

    Sayed Murtaza Sadat Hofiani & Mohammad Hafiz Rasooly

  3. World Health Organisation, Kabul, Afghanistan

    Adela Mubasher

  4. Ministry of Public Health, Kabul, Afghanistan

    Mohammad Khakerah Rashidi

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  1. Aliki Christou
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Correspondence to Aliki Christou.

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Ethical approvals

Ethical approval was provided by the institutional review board of the Afghanistan National Public Health Institute/Ministry of Public Health, Afghanistan (no. 43880) and the ethical review committee of the University of Sydney (no. 2017/566). Written permission was provided from participating hospitals and all participants gave written or verbal informed consent. The study was performed in accordance with the Declaration of Helsinki.

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Christou, A., Alam, A., Hofiani, S.M.S. et al. ‘I should have seen her face at least once’: parent’s and healthcare providers’ experiences and practices of care after stillbirth in Kabul province, Afghanistan. J Perinatol 41, 2182–2195 (2021). https://doi.org/10.1038/s41372-020-00907-5

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