Not conceiving, and losing a pregnancy or a newborn.
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601 to 625 of 627Lived experiences and coping mechanisms of parents following stillbirth and immediate postnatal death: an interpretative phenomenological study from a North Indian setting.
Background: Perinatal bereavement represents a profound rupture in parental expectations, often leaving families in an extended search for closure. While there is substantial research that highlight grief following perinatal loss, understanding how parents cope with such loss is essential for developing sensitive and contextually relevant bereavement care.
Methods: This qualitative study explored the lived experiences of parents who had gone through perinatal loss within six months prior to data collection. Conducted during the formative and early implementation phase (Phase I and II) of the ongoing Strategies to Help in Optimal Pregnancy Outcomes and Reduce Stillbirths in India (SHRiSTI) project, between January and August 2025, in the Palwal district of North India. In-depth interviews (IDIs) were conducted with 15 bereaved parents, including both mothers and fathers. Using thematic an…
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Perinatal Bereavement Simulation for Labor and Delivery Nurses Using a Standardized Patient.
Objective: To assess the interaction and relationship-building skills of nurses caring for an individual experiencing fetal demise, evaluate the effectiveness of simulation to reflect on these skills, and provide recommendations for revision, improvement, and future offerings of simulation experiences.
Design: Guided by the National League for Nursing Jeffries Simulation Theory, this evidence-based practice project provided labor and delivery nurses with an opportunity to participate in a fetal demise simulation scenario with a standardized patient (SP) and receive real-time, constructive feedback about their communication skills.
Setting: The project was conducted in a large academic medical center in northern New Jersey that cares for approximately 50 to 60 individuals/families experiencing fetal demises annually.
Participants: A convenience sample of 23 nurses participated in the expe…
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Parent hospital experiences following stillbirth.
Introduction: Stillbirth is an adverse pregnancy outcome, occurring in approximately 1:160 pregnancies that deeply impacts families and healthcare providers. Best practice guidelines have been established to provide a framework for bereavement care; however, there are still gaps in the provision of care to these parents.
Methods: A qualitative research design in the format of a self-administered online survey was used. Purposive sampling was used to recruit participants in two phases-an open phase and a selected phase. Initial survey data were cleaned, resulting in 200 unique survey responses. The open-ended questions were analyzed using inductive content analysis.
Results: The three main themes generated from the open-ended responses were Memory Making, Support, and Medical Decisions. Despite the majority of healthcare providers offering at least one memory making activity and the major…
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Bereavement Care After Stillbirth in Uttar Pradesh: A Qualitative Analysis of the Present Situation, Challenges, and Solutions.
Background: Bereavement care plays a crucial role in reducing the stress response in mothers who experience stillbirth. However, in India, the delivery of such care remains unregulated and inconsistent and lacks clear protocols and standards. The significant unmet need for bereavement care leads to dissatisfaction among both grieving mothers and caregivers. This study was conducted to assess existing bereavement care practices following stillbirth, identify the challenges faced by healthcare providers, and suggest possible solutions.
Methods: The present study is a qualitative analysis using the medium of in-depth interviews. We used a semi-structured, validated questionnaire and audio-video recording of the interviews. The questions pertained to the existing practices, awareness, challenges faced by healthcare providers and suggestions for improvement at micro- and macrolevel.
Results: …
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Lived Experiences of Labor and Delivery Nurses Caring for Mothers with Stillbirth.
Purpose: Stillbirth profoundly affects women and their partners. Caring for mothers after stillbirth is emotionally difficult for nurses; however, how the nurse feels and copes with this experience is underreported in the literature. The purpose of this study was to explore the lived experience of labor and delivery nurses caring for mothers with stillbirth.
Study design and methods: A qualitative study using Husserl's descriptive phenomenology was conducted. Labor and delivery nurses in the United States who cared for mothers with stillbirth were recruited through the Association of Women's Health, Obstetric and Neonatal Nurses by email. Face-to-face interviews were conducted via Zoom from August to September 2022, until thematic saturation was reached (n = 9). Data were analyzed as described by Colaizzi's phenomenological method. The researchers independently coded transcripts, refined…
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Translation and evaluation of the Perinatal Grief Intensity Scale in Kenya and Uganda.
Background and aim: Stillbirth or neonatal death are distressing life experiences for parents. In many sub-Saharan African countries, bereavement care and support are inadequate. Context-appropriate interventions are needed to improve perinatal bereavement care. To assess whether these interventions work, reliable assessment tools are required. This study aimed to translate and evaluate the Perinatal Grief Intensity Scale [PGIS] for use among bereaved women in Kenya and Uganda.
Methods: A mixed-methods study, involving cross cultural translation, adaptation and psychometric evaluation in Kenya and Uganda. The PGIS was translated into Kiswahili and Luganda with input from community engagement groups and stakeholders. Pilot-testing was conducted in 2 stages; 'Think aloud' interviews (n = 16) and test-retest (n = 20). The finalised tools were tested with 160 women who had experienced stillb…
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Rent S, Bassett E, Nkini G, Sengoka EG, Moyer CA, Lemmon ME, Matthews N, Keating EM, Mmbaga BT, Staton CA, Shayo AM, Docherty SL, Gaffur R (2026)MEDLINE-indexed journal, not yet read by usJournal of reproductive and infant psychology "I expected to be called 'mother': exploring mental health needs of bereaved mothers in Tanzania.
Background: Tanzania has among the highest rates of stillbirth and neonatal death globally, yet little is known about the mental health impact of such loss on mothers. Cultural stigma, silence around grief, and limited access to psychosocial support compound these challenges. This study explores the experiences of bereaved Tanzanian mothers, focusing on mental health symptoms, social support, and preferred forms of post-loss care.
Methods: We conducted a qualitative descriptive study at Kilimanjaro Christian Medical Center (KCMC) in Moshi, Tanzania. Fifty women (25 with stillbirth, 25 with neonatal death) were enrolled. At 8 weeks post-loss, 40 women completed in-depth interviews. Interviews were transcribed, translated, and thematically coded via a directed content analysis combining deductive and inductive coding. A brief intake questionnaire captured demographic data and perceptions o…
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Stage-based bereavement support for parents after stillbirth: an umbrella review.
Background: Stillbirth is a profound and often under-recognised form of perinatal loss that can result in enduring grief. Despite numerous interventions, there is limited synthesis of evidence across the grief trajectory.
Objective: This umbrella review synthesised evidence from systematic reviews to identify bereavement support strategies for parents after stillbirth, structured by stages of grief.
Methods: Six databases and grey literature were searched for qualitative, quantitative, or mixed-methods systematic reviews. Two reviewers independently conducted screening, critical appraisal (JBI tools), and data extraction. A thematic synthesis and corrected covered area matrix addressed overlapping data.
Results: Eleven reviews met the inclusion criteria. Strategies were mapped to three stages: (1) acute grief - empathetic presence, validation of loss, and immediate containment; (2) adjus…
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Attitudes and perspectives of autopsy after a stillbirth: a qualitative study of mothers in Ghana.
Introduction: Stillbirth remains a major global health challenge, with approximately 2.6 million cases reported annually, 98% of which occur in low- and middle-income countries. Autopsy after stillbirth is essential for understanding the underlying causes and informing preventive strategies. In Ghana, autopsies after stillbirth are rarely offered, and many families decline the option even when available. However, research on postmortem uptake in Ghana and sub-Saharan Africa remains limited. This study aimed to explore the perspectives and perceptions of bereaved mothers regarding autopsy after stillbirth in Ghana.
Methods: A qualitative exploratory design was employed to examine mothers' perspectives on autopsy after stillbirth at the Korle Bu Teaching Hospital between January 2020 and June 2021. Participants were identified through hospital labour and delivery records. Convenience sampl…
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Parental experiences of stillbirth rituals in Limpopo, South Africa.
Background: Stillbirth remains a significant global health issue. Although extensive literature exists on burial practices for live births, there is a notable gap in evidence regarding the specific cultural practices related to the burial of stillborn infants.
Aim: This study examines the burial practices surrounding stillbirth from the perspectives of parents using the lens of cultural relativism.
Setting: The study was conducted in the Mopani District, South Africa.
Methods: A qualitative approach was used to conduct in-depth interviews with 12 parents who had experienced stillbirth. Data were analysed using thematic analysis, focusing on burial rituals, beliefs and the meaning of these practices in helping parents process their grief. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was used in preparing the manuscript.
Results: Participants described sev…
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Religious and cultural interpretations of artificial insemination in South-West Nigeria.
Background: In a constantly changing and increasingly globalized world, religion and cultural practices still play a significant role in influencing people's behaviour towards assisted reproductive technologies.
Purpose: This study examined the religious, cultural and personal interpretations of artificial insemination.
Methods: The research methodology was triangulated using qualitative and quantitative methods of data collection. A stratified and simple random sampling technique was used to select the study participants for quantitative data, while, Key Informant Interviews (KIIs) respondents were purposively sampled.
Results: The findings showed that the majority of the respondents were aware of artificial insemination, 75.3% of the respondents had adequate knowledge of artificial insemination. About 54.2% of the respondents agreed that their religious denominations supported any form…
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Exploring the Social Networks of Women Bereaved by Stillbirth: A Descriptive Qualitative Study.
The loss of a baby to stillbirth is a traumatic experience and can lead to secondary losses, such as the loss of social relationships. In Nigeria, stillbirths are a common public health problem. However, limited attention has been given to the social ramifications of stillbirths. This study describes the social networks of women who have experienced a stillbirth and the factors influencing their social networks. Interviews and social network diagrams were used to collect data from 20 women about their social networks before and after stillbirth. Findings suggest that the experience of shame, unmet expectation of support, and a lack of trust led to relationship changes after stillbirth. Most participants met bereavement needs with their existing social networks before stillbirth, but many participants also experienced relationship losses (even among family networks). Information from soci…
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Mapping Hospital-Based Lactation Care Provided to Bereaved Mothers: A Basis for Quality Improvement.
Objective: The study aimed to identify and map the factors that shape the delivery of hospital-based lactation care for bereaved mothers to inform quality improvement initiatives targeting hospital-based lactation care. Methods: Focus groups and interviews were conducted at three large hospitals in Australia with 113 health professionals including obstetricians, neonatologists, midwives, neonatal nurses, lactation consultants, social workers or pastoral care workers, Human Milk Bank (HMB) staff, and perinatal bereavement nurses. Thematic and interactional data analysis identified the nature, scope, and pattern of bereavement lactation care. Results: A bereaved lactation care pathway was generated from health professionals' reports. Bereaved lactation care, if provided, was limited to brief encounters aimed at facilitating lactation suppression. The type of lactation care offered, and any…
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Patient experiences of fertility clinic closure during the COVID-19 pandemic: appraisals, coping and emotions.
Study question: What are appraisals, coping strategies and emotional reactions of patients to coronavirus disease 2019 (COVID-19) fertility clinic closures?
Summary answer: Clinic closure was appraised as stressful due to uncertainty and threat to the attainability of the parenthood goal but patients were able to cope using strategies that fit the uncertainty of the situation.
What is known already: Psychological research on COVID-19 suggests that people are more anxious than historical norms and moderately to extremely upset about fertility treatment cancellation owing to COVID-19.
Study design, size, duration: The study was of cross-sectional design, comprising a mixed-methods, English language, anonymous, online survey posted from April 9 to 21 to social media. Eligibility criteria were being affected by COVID-19 fertility clinic closure, 18 years of age or older and able to complete …
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Child marriage and its association with adverse reproductive outcomes for women in Bangladesh.
This study examines the prevalence of child marriage and its effect on reproductive outcomes among women in Bangladesh using the most recent 2011 Bangladesh Demographic and Health Survey data. Both bivariate and multivariate statistical techniques used in the study yielded quantitatively important and reliable estimates of child marriage and its impact on adverse reproductive and health outcomes. Overall, 77% of the marriages among women aged 20 to 49 years old took place before the age of 18 years. Women's education is the most single significant determinant of child marriage. Findings revealed that after being adjusted for sociodemographic factors, child marriage significantly (P < .001) increases the likelihood of stillbirth/miscarriage (odds ratio [OR] = 1.80; 95% confidence interval [CI] = 1.45-2.24) and pregnancy termination (OR = 1.24; 95% CI = 1.12-1.38). Programs should aim to r…
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Sexual and gonadal dysfunction in chronic kidney disease: Pathophysiology.
Sexual and gonadal dysfunction/infertility are quite common in patients with chronic kidney disease. Forty percent of male and 55% of female dialysis patients do not achieve orgasm. The pathophysiology of gonadal dysfunction is multifactorial. It is usually a combination of psychological, physiological, and other comorbid factors. Erectile dysfunction in males is mainly due to arterial factors, venous leakage, psychological factors, neurogenic factors, endocrine factors, and drugs. Sexual dysfunction in females is mainly due to hormonal factors and manifests mainly as menstrual irregularities, amenorrhea, lack of vaginal lubrication, and failure to conceive. Treatment of gonadal dysfunction in chronic kidney disease is multipronged and an exact understanding of underlying pathology is essential in proper management of these patients.
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Magon N (2011)MEDLINE-indexed journal, not yet read by usIndian journal of endocrinology and metabolism58 citations Gonadotropin releasing hormone agonists: Expanding vistas.
Gonadotropin-releasing hormone (GnRH) agonists are derived from native GnRH by amino acid substitution which yields the agonist resistant to degradation and increases its half-life. The hypogonadotropic hypogonadal state produced by GnRH agonists has been often dubbed as "pseudomenopause" or "medical oophorectomy," which are both misnomers. GnRH analogues (GnRH-a) work by temporarily "switching off" the ovaries. Ovaries can be "switched off" for the therapy and therapeutic trial of many conditions which include but are not limited to subfertility, endometriosis, adenomyosis, uterine leiomyomas, precocious puberty, premenstrual dysphoric disorder, chronic pelvic pain, or the prevention of menstrual bleeding in special clinical situations. Rapidly expanding vistas of usage of GnRH agonists encompass use in sex reassignment of male to female transsexuals, management of final height in cases…
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Differences in Perinatal Outcomes of Birthing People in Same-Sex and Different-Sex Marriages.
It is unknown whether people in same-sex relationships who give birth have different perinatal outcomes than people in different-sex relationships, despite differences in risk factors such as use of assisted reproductive technologies, obesity, smoking, and poor mental health. Marriage equality has established birth certificates as a promising new source of population-based data on births to same-sex married parents. We used birth certificate data from Massachusetts for 201,873 singletons born to married parents from 2012 to 2016. We estimated the associations of several birth outcomes with having a birth parent in a same-sex marriage using propensity score-matched and -unmatched samples. We also tested whether these associations were modified by the use of assisted reproductive technologies. People in same-sex marriages who gave birth had perinatal outcomes related to decreased fetal gro…
matched on Reproductive Techniques, Assisted (mesh)
Changes in Mental Health of Women Undergoing Assisted Reproductive Technology Treatment During the COVID-19 Pandemic Outbreak in Xi'an, China.
Objective: To investigate the mental health of women undergoing assisted reproductive technology (ART) treatment during the novel coronavirus pneumonia (COVID-19) pandemic outbreak in Xi'an, China. Methods: A repeated cross-sectional study was administered to women undergoing ART treatment during the outbreak period (599 women in February 2020) and the control period (892 women in May 2020) at the Northwest Women's and Children's Hospital, Xi'an, China. Results: Both the ART-treated women surveyed during the outbreak period and those surveyed during the control period had high scores on the fear dimension (0.88, 0.51). The total scores for mental health among the participants during the control period were lower than those during the outbreak period (difference = -0.22; 95% CI = -0.25, -0.18). Lower scores were also seen during the control period, compared to those in the outbreak period…
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The Muslim Ban and preterm birth: Analysis of U.S. vital statistics data from 2009 to 2018.
Anti-immigrant stigma or xenophobia is increasingly pervasive globally. Racism is a determinant of adverse health outcomes, but the epidemiological implications of the recent wave of xenophobic policies have not been well studied. The 2017 travel ban on individuals from Muslim majority countries is an example of such policy efforts in the United States. Using the 2009-2018 National Center for Health Statistics period linked infant birth-death data, we used time series methods to compare the monthly odds of preterm births to women from travel ban countries (Iran, Iraq, Libya, Somalia, Sudan, Syria, and Yemen) after the January 2017 travel ban to the number expected had the ban not been implemented. We estimated our counterfactual from the history of preterm birth among women born in countries included in the ban as well as trends in preterm birth among native-born non-Hispanic (NH) White …
matched on Reproductive Techniques, Assisted (mesh)
Prevalence of child marriage and its impact on fertility outcomes in 34 sub-Saharan African countries.
Background: The issue of child marriage is a form of human rights violation among young women mainly in resource-constrained countries. Over the past decades, child marriage has gained attention as a threat to women's health and autonomy. This study explores the prevalence of child marriage among women aged 20-24 years in sub-Saharan Africa countries and examines the association between child marriage and fertility outcomes.
Methods: Latest DHS data from 34 sub-Saharan African countries were used in this study. Sixty thousand two hundred and fifteen women aged 20-24 years were included from the surveys conducted 2008-2017. The outcome variables were childbirth within the first year of marriage (early fertility), first preceding birth interval less than 24 months (rapid repeat of childbirth), unintended pregnancy, lifetime pregnancy termination, the use of modern contraceptive methods, li…
matched on Infertility, Female (mesh)
Persistent depressive and grief symptoms for up to 10 years following perinatal loss: Involvement of negative cognitions.
Background: Perinatal loss is known to be associated with a heightened risk of mental health complications. However, the psychological mechanisms underlying the perinatal grief process are less well documented. We hypothesized that negative cognitions are associated with post-perinatal loss symptomatology, and vary according to whether the death occurs before or after birth.
Methods: We adopted a cross-sectional design to assess demographics, variables related to the death, five types of negative cognitions (about the self, world, life, future, and self-blame), prolonged grief, and depressive symptoms. The sample included 98 perinatally bereaved mothers with a mean age of 33.9 years.
Results: When we controlled for demographics and variables related to the death, hierarchical linear regression showed that maladaptive cognitions about life, the future and the world were associated with pr…
matched on Perinatal Death (mesh)
Pregnancy wantedness, frequency and timing of antenatal care visit among women of childbearing age in Kenya.
Background: A woman's health seeking behaviour during pregnancy has been found to have significant repercussions on her wellbeing and that of her unborn child. For example, the risk of poor pregnancy outcomes and maternal death is higher among women who do not receive antenatal care.
Methods: The study described the characteristics of women who reported wanted, unwanted and mistimed pregnancies from their last birth at the time of the survey; the linkage between frequency of antenatal care visits and pregnancy wantedness and the relationship between timing of the first antenatal care visit and pregnancy wantedness since maternal morbidity and mortality are higher among women who do not receive antenatal care. The 2008-09 Kenya Demographic and Health Survey data is used and multinomial logistic regression and logistic regression informed the study analysis.
Results: Results showed that wo…
matched on Pregnancy Rate (mesh)
Palliative Care in Obstetrics and Gynecology.
Palliative care is specialized care for people with life-limiting illness; it focuses on symptom management and quality of life and ensures that a patient's care is concordant with her goals and values. Unlike end-of-life care, palliative care can be offered concurrently with disease-directed therapies, including when the goal is cure. Obstetrics and gynecology patients for whom palliative care is most appropriate include women with gynecologic cancer and women with a fetus or neonate with a potentially life-limiting illness. Integration of palliative care for these patients offers both clinical and health care utilization benefits, including improved symptom management, improved quality of life, and high-value care. Palliative care can be provided by palliative care specialists (specialty palliative care) or by the team treating the life-limiting illness (primary palliative care), depen…
matched on Perinatal Death (mesh)
Building extended families through embryo donation: the experiences of donors and recipients.
Study question: How do embryo donors and recipients understand and experience embryo donation (ED)?
Summary answer: Donors and recipients regard the genetic link between donors and donor-conceived child as significant, and draw on metaphors of ED as adoption and as building extended family networks in order to manage the complex interplay of genetic, gestational and social aspects of reproduction and family-building.
What is known already: The uptake of embryo donation internationally is relatively low and there has been little research into the outcomes and experiences of ED for donor and recipient families.
Study design, size, duration: Embryo donors and recipients in New Zealand were interviewed between March and October 2012 as to their understandings and experiences of embryo donation.
Participants/materials, setting, methods: Participants were recruited from across New Zealand and …
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