The quality of intrapartum care during stillbirth deliveries in conflict-affected Nigeria and Democratic Republic of Congo: A phenomenological study.

Abstract

Stillbirths are traumatic, and their consequences can be exacerbated by inadequate care and support during and after such devastating loss. Little is known about these issues in conflict-affected regions. Qualitative interviews were conducted to understand the quality of intrapartum care among women with stillbirth deliveries in health facilities in conflict-affected areas of Yobe, Nigeria, and North-Kivu and South-Kivu, Democratic Republic of Congo. Thematic analysis guided by the WHO Quality of Care framework revealed variations in women's experiences of care. While some reported positive experiences, many highlighted poor communication, lack of emotional support, and violations of dignity. Many felt excluded from decisions about their care and reported lack of clarity on reasons behind healthcare decisions. Furthermore, many reported poor psychological support. Cultural norms and limited resources exacerbated these challenges. Despite living in a crisis-affected context, concerns with safety were minimal and limited to nighttime insecurity at health facilities. Overall, extensive gaps in the quality of care provided to women experiencing stillbirth were identified. Our results call for healthcare systems to prioritize patient-centered care that is empathetic, culturally sensitive, and responsive to needs of grieving mothers. Governments and other stakeholders should urgently address these issues to improve the experience of childbirth.