Why the NIHR Stillbirth Prevention and Management Group is important

Blog 4 Jun 2020
Raheli Mukhwana  Research Assistant, LAMRN Kenya

When I attended my nurse training at the Kenya Medical Training College in my twenties, I did not know that one day I would be a midwife. As a midwife, I found myself working long hours to ensure that mother and child were safe. I have been working in the Labour ward of Kenyatta National Hospital where 1400 births are made each month, meaning so many women would pass through my hands. I would celebrate with them for their successful births.

In this experience, one thing has always disturbed me: women who came expectant and did not have a desirable outcome. Stillbirths have social and cultural implications to parents in Kenya. As a Research Assistant now, working with Lugina Africa Midwives Research Network and The University of Manchester it became clear to me that this was not just a Kenyan problem but also a global problem. With 2.6 million stillbirth every year, 64% happening in Sub-Saharan Africa, I knew this was my question that needs answers.

While conducting in-depth interviews on the experiences of parents and healthcare providers around stillbirth for the NIHR Global Health Research Group on Stillbirth Prevention and Management, I realized I needed to do more as a midwife for these parents. Parents’ desperation needed attention. After their loss, they demand for the same quality of care as the women who birth healthy babies. I realized that the quality of the service provided in our facility was not dependent on whether you were from an urban or a rural setting, the care was the same. However, it was apparent some urban women could access better health care and afford private consultations, ordinary and rural women were mostly under the mercies of the public health facilities, which lacked equipment and have limited resources.

Interventions at critical times during birth can prevent many stillbirths. In fact, complications during labour and childbirth account for around half of the stillbirths. Parents are broken by the lack of support from their families and the healthcare givers.

As a Research Assistant, I learnt that we should not ignore the calls for help, or disregard the information women provide us about the care received. Our research highlighted that parents who had stillbirths believe that bereavement care at some hospitals is almost non-existent and some providers’ attitude is totally devoid of compassion. Healthcare providers are not trained to break bad news to families. Women who had experienced stillbirth feel that the healthcare providers, in many cases, are lacking empathy.

As we get to the intervention phase of our study, we identified bereavement champions and peer supporters as a way to provide individualised care to these women in need. This is the first step in the right direction.

With time, I know we will be better in providing care following stillbirths. We will continue to listen to the parent’s requests and use their feedback to inform future interventions. It always feels nice to run into a mum who tells me that she has recovered from the loss and is now thinking of having a baby again.