A Qualitative Study of Attitudes and Values Surrounding Stillbirth and Neonatal Mortality Among Grandmothers, Mothers, and Unmarried Girls in Rural Amhara and Oromiya Regions, Ethiopia: Unheard Souls in the Backyard. (January 2014)

• Record Type: Journal Article
• Authors: Sisay, Mitike Molla; Yirgu, Robel; Gobezayehu, Abebe Gebremariam; Sibley, Lynn M.
• Is Part Of: Journal of midwifery & women's health. Volume 59:Number 1(2014:Jan./Feb.)
• Page Start: S110
• Page End: S117
• Publication Date: 2014-01
• Subjects: Midwives -- Periodicals; Obstetrics -- Periodicals; Women's health services -- Periodicals; 618.2
• DOI: 10.1111/jmwh.12156
• Languages: English
• ISSNs: 1526-9523

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jmwh12156-sec-0010" sec-type="section"> <title>Introduction</title> <p>In Ethiopia, neonatal mortality and stillbirth are high and underreported. This study explored values related to neonatal mortality and stillbirth and the visibility of these deaths in rural Ethiopia among 3 generations of women.</p> </sec> <sec id="jmwh12156-sec-0020" sec-type="section"> <title>Methods</title> <p>We conducted a qualitative study in 6 rural districts of the Oromiya and Amhara regional states during May 2012. We included 30 focus groups representing grandmothers, married women (mothers), and unmarried girls in randomly selected <italic>kebeles</italic> (villages).</p> </sec> <sec id="jmwh12156-sec-0030" sec-type="section"> <title>Results</title> <p>Until the 40th day of life, neonates are considered to be strangers to the community (not human). Their deaths are not talked about; they are buried in the house or in the backyard. Mothers are forbidden to mourn their loss lest they offend God and bring on future neonatal losses. Women who repeatedly lose their neonates may be blamed, mistreated, and dishonored through divorce. Neonatal death and stillbirth are attributed to supernatural powers, although some women and girls associate these deaths with poverty and lack of education. The desire for increased visibility of neonatal death is mixed. Unlike the grandmothers and unmarried girls, most of the married women want death to be visible to draw the attention of policy makers. Women prefer home birth and consider themselves lucky to be able to give birth at home. At present, there is no national vital registration system.</p> </sec> <sec id="jmwh12156-sec-0040" sec-type="section"> <title>Discussion</title> <p>Neonatal death and stillbirth are hidden and the magnitude is likely underrepresented. The delayed recognition of personhood, attribution of death to supernatural causes, social repercussions for women who experience a pregnancy loss, preference for home birth, and lack of a vital registration system all contribute to the invisibility of perinatal deaths. Increasing the visibility of (and counting) these deaths may require multifaceted behavior‐change interventions.</p> </sec> </abstract>