HEALTH SYSTEM AND PATIENT-RELATED FACTORS AFFECTING WOMEN AFTER STILLBIRTH IN PORT HARCOURT

Abstract

Background: Nigeria makes a substantial contribution to the global burden of stillbirths. However, data on women’s experiences and care received at the time of stillbirth are limited. This study aimed to investigate the experiences and patientrelated and health system factors in women who had a stillbirth in a previous pregnancy in the past 15 years. 

Methodology: This was a cross-sectional survey of 64 pregnant women, attending antenatal care in Port-Harcourt, who had stillbirth in a previous pregnancy. Consenting participants were interviewed using a predesigned and pretested questionnaire. Information on sociodemographic characteristics, pregnancy history including health-seeking behaviour in the stillbirth pregnancy, and women’s experiences and appraisal of care provided by healthcare workers during the stillbirth event, were collected. Data was analysed using descriptive statistics and presented as numbers, Means and Percentages in tables.

Results: Most participants (92.2%) experienced one stillbirth. The majority (71.9%) had stillbirths at 9 months gestation. Almost all pregnancies (98.4%) were singleton, and most mothers (81.3%) reported attending antenatal care regularly. The majority of deliveries (89.1%) occurred in healthcare facilities. Post-stillbirth, 45.3% of the mothers stayed in an open postnatal ward, 56.3% saw their stillborn child, with 39.1% of them not seeing the baby at all, and only 4.69% saw and held their dead baby. Over half (56.3%) found healthcare workers supportive and satisfied with their role, but (45.3%) did not receive postnatal care or counselling. Concerning performing an autopsy, 60.9% would not have requested one.

Conclusion: Most stillbirths were term pregnancies, occurred intrapartum, and were in-facility deliveries. Delays in reporting complications and receiving care at the hospital contributed to the stillbirths. A good proportion of the women were not shown and did not hold their babies and were admitted to a standard postnatal ward following delivery, factors which are predictive of increased psychological morbidity. However, most women were satisfied with the care and support they received from healthcare workers during the delivery.