By: Anita Cheng
The Lancet recently released a collection of papers regarding stillbirths as an often overlooked statistic. According to this article, a stillbirth is defined as a baby born without signs of life after 28 weeks of gestation. This article highlights how stillbirths are often not counted in developing countries. The absence of this statistic prevents any goals or commitments from being established to prevent stillbirths. An interesting finding is that the causes of stillbirth are almost identical to those of maternal or neonatal deaths. Some examples include labor complications, maternal infections, high blood pressure, and diabetes. Similarly, preventing stillbirths involve better emergency obstetric care, folic acid supplements, malaria prevention, and improved detection and management of syphilis during pregnancy.
With the enormous focus on child health and maternal health in the Millennium Development Goals, I am surprised that stillbirths have been neglected. What is even more surprising is how, like maternal deaths, it is almost completely preventable, regardless of the development status of a country. While reading this article, I began thinking about the effects a stillbirth has on the mental health of a mother. The quote: “The grief of a stillborn is unlike any other form of grief: the months of excitement and expectation, planning, eager questions and the drama of labor — all magnifying the devastating incomprehension of giving birth to a baby bearing no signs of life” struck me deeply. Having previously done research on scarce mental health care resources not only in well-developed countries like the United States but also under-developed countries, in which the majority of stillbirths in the world occurs, I am concerned about the mental health of these mothers. While mothers in wealthier nations are able to seek out and afford mental health care to deal with the grieving process of a stillbirth, mothers in under-developed nations do not have this privilege and may be disproportionately at greater risk for psychiatric consequences associated with this type of pregnancy loss. Examples of these psychiatric consequences include depression and anxiety.
This report exemplifies how injustices beget injustices. In the first place, mental health disabilities carry an enormous stigma from First world to Third world cultures. Aside from being impacted by systematic disadvantages that prevent these mothers in under-developed nations from receiving proper pre-natal care, they are barred from proper mental health care after the traumatic experience of stillbirth. The loss of a child is an emotionally jarring experience and if this immense grief is not dealt with, poor mental health can lead to physical health consequences. Not only must public health practitioners work on providing prenatal and maternal care for all mothers but also address the dire need for appropriate psychological health care.