Shifts in social support: A phenomenographic study of Nigerian women who have had a stillborn baby

Abstract

Each year in Nigeria 314,000 mothers lose their babies to stillbirth. This study investigates the implications of these stillbirths for Nigeria’s Yoruba women, especially in relation to their social networks. The study is theoretically framed within the theory of social capital and the research methodology is phenomenography, a qualitative approach that concerns itself with difference in relation to experience. Twenty mothers of stillborn babies were purposefully recruited from Saki, a Yoruba community in South-west Nigeria. Data were collected through semi-structured interviews, participants’ drawings and a focus group discussion. The transcribed data were analysed according to the principles of phenomenography. This yielded four broad categories: (1) relationships change; (2) relationships matter; (3) material support makes a difference; and (4) health professionals neither help nor support. These findings indicated that stillbirth interfered with the social networks of the participants, leading to a decline in their social networks and an emergence of the family as the primary source of support. The participants gained encouragement and empathy through their relationships with others but received minimal material support, even though it was badly needed. The participants expressed distrust in health professionals due to a lack of compassionate care. This study contributes to the understanding of stillbirth bereavement in three different ways. First, culture really matters in how mothers of stillborn babies express their grief, how they are supported and how they would want to be supported. Second, there is still a deficit of kind, compassionate and skilled nursing care for mothers of stillborn babies. Third, support becomes smaller, but more intense for mothers after suffering a stillbirth. This study, therefore, adds to the ongoing global conversations about how better bereavement care can become more realistic for mothers of stillborn babies by extending the theory of social capital and the methodological approach of phenomenography to the issue of stillbirth bereavement. The study concludes with recommendations for nursing, for research and for policy.