Yatera Hashim, Joho Angelina A, Masika Golden M
Department of Clinical Nursing, School of Nursing and Public Health, The University of Dodoma, Dodoma, Tanzania.
PLoS One. 2025 Sep 2;20(9):e0331319. doi: 10.1371/journal.pone.0331319. eCollection 2025.
In Tanzania, stillbirth is a public health challenge. The care provided to women after stillbirth does not reflect standards. Little is known on view of the social and clinical human experience surrounding this tragedy. This study explored women lived social-cultural and clinical experiences and the navigation process after stillbirth in Dodoma.
A phenomenological qualitative approach was conducted from February 15, 2024, to May 30, 2024, involving in-depth interviews with 12 informants (postnatal women) who were purposefully selected, achieving data saturation at 9 informants. Data were transcribed verbatim, manifest coded, and analysed using conventional content analysis. Subsequently, sub-categories and main categories were generated. At the theorizing phase, the conceptual interpretation of categories and subcategories were used to generate the conceptual framework that describes the phenomenon of women's navigation process from the experienced life challenges towards maintaining the overall well-being after stillbirth.
The study identifies six main categories of exposure, each with three subcategories: ① Unsatisfactory medical care (dissatisfaction with medical care, neglected bereavement care, and improper breaking of information); ② Diversity and adversity in cultural practices (dominance of elders' power, diversity of cultural practice and emotional responses); and ③Diversity in social practices (diversity of social responses towards the news, diversity in social responsibilities and diversity experience after social responses), ④ Meaning constructed after still birth (unpleasant phenomenon of stillbirth, all suffering for nothing, the baby could be saved), ⑤ Mental and physical health challenges (anxiety and depression, post-traumatic stress disorder, and physical burden of still birth), ⑥ Navigating the stillbirth experiences (self-coping, social support and hospital support).
The study found that women who experience stillbirth face significant social, cultural, and psychological challenges that impact their perception and meaning of their world and their mental wellbeing. Ultimately, they invariably navigate to a state of well-being. This highlights the urgent need for culturally sensitive interventions and dedicated healthcare and social support systems to help mothers recover smoothly and swiftly.
在坦桑尼亚，死产是一项公共卫生挑战。死产后为妇女提供的护理未达标准。对于围绕这一悲剧的社会和临床人文体验了解甚少。本研究探讨了多多马地区妇女在死产后的社会文化和临床经历以及应对过程。
于2024年2月15日至2024年5月30日采用现象学定性研究方法，对12名被有意挑选的受访者（产后妇女）进行深入访谈，在访谈9名受访者时达到数据饱和。数据逐字转录、进行显性编码，并采用常规内容分析法进行分析。随后，生成子类别和主要类别。在理论化阶段，利用类别和子类别的概念解释来生成概念框架，该框架描述了妇女从经历生活挑战到在死产后维持整体幸福感的应对过程这一现象。
该研究确定了六个主要暴露类别，每个类别有三个子类别：①医疗护理不尽人意（对医疗护理不满、忽视丧亲护理以及信息告知不当）；②文化习俗的多样性和逆境（长辈权力主导、文化习俗多样性和情感反应）；③社会实践的多样性（对消息的社会反应多样性、社会责任多样性以及社会反应后的多样经历）；④死产后构建的意义（死产的不愉快现象、一切痛苦皆徒劳、婴儿本可挽救）；⑤身心健康挑战（焦虑和抑郁、创伤后应激障碍以及死产的身体负担）；⑥应对死产经历（自我应对、社会支持和医院支持）。
该研究发现，经历死产的妇女面临重大的社会、文化和心理挑战，这些挑战影响她们对世界的认知和意义以及心理健康。最终，她们总会走向幸福状态。这凸显了迫切需要开展具有文化敏感性的干预措施以及专门的医疗保健和社会支持系统，以帮助母亲顺利快速康复。
