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The findings from a case‐control study of perinatal deaths occurring within a health authority during 1982 are described. No clear‐cut picture between cases and controls emerged for a range of social, maternal and access to service variables. The tentative findings suggested that, once mothers were in the health care system, differences in medical practice and attitudes might be related to perinatal outcome. Participant observation led to the identification of problems in communication between the mothers and some members of medical staff. This led to “victim‐blaming” and to mothers′ anxieties not being taken seriously, sometimes with serious consequences. It is suggested that “victim‐blaming” behaviour has its roots in the deep and long‐term processes of medical socialisation. How the range of explanations for inequalities in health, set out in the Black Report, may be implicitly adopted in inconsistent ways in the delivery of health care to this particular group, is illustrated.

The purpose of this paper is to examine the silences and silencing in the workplace and elsewhere related to women's experiences of perinatal loss.

Qualitative data from in‐depth interviews with 13 women who experienced perinatal losses between 1965 and 1999 are interpreted using Foucault's concepts of power/knowledge as pervasive in social relationships.

Women who experienced perinatal loss were physically divided from others in hospitals. Hospital practices changed over time. Knowledge about perinatal loss has been scientifically classified in medicine, psychology, and related fields. This knowledge has changed between 1965 and 1999. Perinatal loss is rarely mentioned in organizational and professional literatures outside of health care. In addition to experiencing silencing from others, women silenced themselves about their perinatal losses.

Data were collected from interviews with women from the Great Lakes region of the USA. Further research should include a greater number of parents from a wider geographic area.

Dividing practices and silences collect a toll in depression, severed relationships, derailed careers, and missed opportunities for development. As people begin to speak with one another about perinatal loss, their voices contribute to a fully human work community and polyphonic organizations.

This paper makes a contribution to knowledge about perinatal loss and its impact on women's careers and grief in the workplace from a postmodern perspective.

Each year approximately 3,200 women have a stillbirth in the UK. Although national evidence-based guidance has existed since 2010, case reviews continue to identify suboptimal clinical care and communication with parents. Inconsistencies in management include induction and management of labour and the frequency of investigation after stillbirth. The paper aims to discuss these issues.

An audit of stillbirths was performed in 2014 in 13 maternity units in the North West of England, this confirmed variation in practice described nationally. An integrated care pathway (ICP) was developed from national guidelines to enable optimal care for the management of stillbirth, reduce variation, standardise investigations and coordinate patient-focussed care. This was launched in 2015 and updated in 2016 to resolve the issues that were apparent after implementation.

Each participating unit had commenced using the ICP by May 2015. Following implementation there were changes in care, most notably from diverse methods for the induction of labour to guideline-directed induction of labour. There were trends towards better care in terms of information given, choices offered, more appropriate analgesia in labour and improved post-delivery investigation for cause. Staff feedback about the ICP was positive.

The use of this ICP improved care for women who had a stillbirth and their families. Issues with implementing a changed care pathway meant that further iterations were required, ongoing improvement is expected following the refinement of the ICP.

ICPs have been used for various clinical conditions. However, this is the first example of their use in women who had a stillbirth.

Sixteen million adolescents give birth each year, constituting 11% of all births worldwide. Adverse adolescent pregnancy outcomes are well-documented. Available data on adolescent pregnancies have mainly relied on self-reported age and retrospective survey data, which might not capture adolescent births accurately. This paper reports on trends in adolescent pregnancy and associated adverse birth outcomes in Matlab, Bangladesh, using data from the Matlab Heath and Demographic System (HDSS) which precisely documents maternal age.

The study was conducted in the rural subdistrict of Matlab in Bangladesh. HDSS data were used to examine trends in adolescent motherhood (10–19 years) in the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b) service areas (ISA) and government service areas (GSA) between 2007 and 2015. A total of 4,996 adolescent mothers were included in the analysis. Chi-square testing and binary logistic regression were used to document adolescent pregnancy trends and the differences in and causes of perinatal death.

The fertility rate was 27 per 1000 adolescent mothers in ISA and 20 per 1000 adolescent mothers in GSA, during the 9 years of the study period. The adjusted odd of an adolescent mother having a perinatal death in ISA, relative to GSA was 0.69. Significant determinants of perinatal death among adolescent mothers included maternal education, paternal education, mother’s age at first birth, asset score and distance from the nearest health facility.

This paper documents the real trend of adolescent pregnancy by capturing the accurate age at pregnancy for the first time in Bangladesh.

The purpose of this paper is to provide a situational overview of the facility-based maternal and perinatal morbidity and mortality audits (MPMMAs) in SSA, their current efficacy at reducing mortality and morbidity rates related to childbirth.

This is a scoping literature review based on the synthesis of secondary literature.

Not all countries in SSA conduct MPMMAs. Countries where MPMMAs are conducted have not instituted standard practice, MPMMAs are not done on a national scale, and there is no clear best practice for MPMMAs. In addition, auditing process of pediatrics and maternal deaths is flawed by human and organizational barriers. Thus, the aggregated data collected from MPMMAs are not adequate enough to identify and correct systemic flaws in SSA childbirth-related health care.

There are a few published literature on the topic in sub-Saharan Africa.

This review exposes serious gaps in literature and practice. It provides a platform upon which practitioners and policy makers must begin to discuss ways of embedding mortality audits in SSA in their health systems as well as health strategies.

The findings of this paper can inform policy in sub-Saharan Africa that could lead toward better outcomes in health and well-being.

The paper is original.

The mortality rate due to intrapartum asphyxia is generally considered a good guide to the quality of perinatal care. Using a routine system of surveillance, we identified a six‐fold difference in mortality rate due to intrapartum asphyxia depending on the hospital of birth, with the lowest rate (95 per cent confidence intervals) of 0.25 (0.10, 0.64)/1,000 births and the highest rate of 1.59 (0.77, 3.27)/1,000 births. A framework of internal and external reviews of the clinical services was developed, that is able to tackle such clinical governance issues in a robust but sensitive manner. The outcome included specific improvements in service provision. The model is generally applicable and is thus suitable for use wherever such clinical governance issues are identified.

The purpose of this paper is to explore the impact of pregnancy or baby loss on families, and their ability to access suitable support. Miscarriage and stillbirth are not rare events and losing a baby can have an overwhelming and long-term impact on parents and on existing and subsequent children.

This paper provides an overview of current relevant research, policy and practice.

Much research and service provision focuses on pregnancy or baby loss for parents without living children. This is predicated on the widely held assumption that existing children provide a protective factor mitigating the loss and going on to have another child is the best antidote to grief. Research does not substantiate this but highlights the difficulties parents experience when coping with pregnancy or baby loss alongside the needs of looking after existing children.

The identification of a “hidden” group of parents and children whose mental health and wellbeing is at risk without the provision of services. A tailored approach to the needs of the family is called for, including greater collaboration between statutory and third sector organisations.