Dissertation (MSc Midwifery)
Stillbirth is a silent traumatic canker that is a major concern of various individuals, health institutions, and the country as a whole. All over the world researchers are fighting tooth and nail to unravel the mystery surrounding the high prevalence of stillbirths. This study was carried out in Pwani region with the aim of finding the predictors associated with stillbirth among post-delivery mothers.
A matched case-control study with a ratio of 1:2, conducted in Pwani region from May to early of August 2020 of which 65 post-delivery mothers faced stillbirths (Cases), and 130 postdelivery mothers with live borns (Controls) were enrolled. Interviewer-administered questionnaires and documentary reviews were used for data collection. Data were analyzed by using SPSS version 20.
All post-delivery mothers were enrolled, including 65 post-delivery mothers with stillbirths, and 130 post-delivery mothers with live borns, during the study. Post-delivery with high parity above 4 para, and women with less access to antenatal care were at increased risk of stillbirth. Mothers who were anaemic during admission to labour ward were more likely to have stillbirth compared to those who were not anaemic (AOR=4.690, p value=0.000). Furthermore, post-delivery mothers, who had not received a dose of sulfadoxine pyrimethamine, malaria in pregnancy, folic acid intake were more likely to have stillbirths, compared to live births, stillbirths were more likely to be preterm (AOR=4.024 95%, p value= 0.001), and post-delivery mothers taken local herbs during pregnancy as association with stillbirths (AOR=4.738, p value=0.000). Fetal presentation none other than cephalic was associated with stillbirth (AOR=12.591, p value= 0.000), birth weight <2.5kgand >4kg, and cord around the neck (AOR=15.326, p value=0.000).
In addition, Obstetric factors associated with stillbirths were observed as post-delivery mothers who were referred from another facility (AOR=17.716, p value=0.000), history of cord prolapse was relatively more likely to be associated with stillbirths (AOR=13.656, p value=0.001). Furthermore, post-delivery mothers with a history of early rupture of membrane (before labour) more likely to be associated with stillbirth compared with rupture of the membrane during labour (AOR=29.819, p value=0.000).
Based on the results of the study, Stillbirth rate is still existing in Pwani Region hence is a major concern, appeared to be mostly associated with maternal factors, fetal factors, and obstetric factors.
Improve uptake of ANC among pregnant mothers and reproductive age, empowering girls to prevent teenage pregnancy as stated by Sustainable development goal 5, improve health care provision and Hospital readiness for pregnancy emergencies.