Interpretations of stillbirth

Journal of Advanced Nursing
Volume 47 Issue 4 Page 408  - August 2004
doi:10.1111/j.1365-2648.2004.03119.x 

Interpretations of stillbirth 

Min-Tao Hsu PhD RN, 
Ying-Fen Tseng MSN, 
Janet M. Banks PhD RN and 
Ling-Lih Kuo MSN 

Background.
Continuity is a major concept in the father-son domain of the Han Chinese value 
system in Taiwan. Aspects of continuity may include structure, interactions and 
other facets of family; however, providing descendants is the keystone of women's 
reality in these families. In a culture in which death is seen as a taboo subject 
and the unborn child has not been recognized as a real baby, losing a long-expected 
child at the end of pregnancy becomes a great challenge to women who have experienced 
stillbirth.

Aim.
The aim of this paper is to report a study exploring Taiwanese mothers' interpretations 
of stillbirth, and their unique sociocultural context.

Method.
An interpretive ethnographic approach was used. Over a two and a half-year period, 
20 women who had experienced such losses after at least 20 weeks of pregnancy 
were interviewed to find out how they interpreted their babies' deaths. Interview 
data were analysed thematically.

Findings. 
The four major themes identified were: 'loss of control', 'broken dream', 
'shattered self' and 'something wrong with me'. Interpretations of stillbirth 
among Taiwanese women indicate a strong sense of incompleteness and personal 
failure, triggering reactions in terms of not only maternal identity, but also 
female cultural roles. Many interviewees blamed themselves for the deaths of their 
unborn children, a viewpoint resulting in excessive guilt feelings.

Conclusion. 
Culturally bound taboos against talking about death, participating in death-related 
events, and expressing grief in public affect the adaptation and grieving 
processes of Taiwanese women who have had a stillbirth. Nurses should, therefore, 
make an effort to listen to the perspectives of such patients in order to assist 
them with coming to terms with their loss. As part of their education, nurses 
require information on cultural beliefs so that they can provide appropriate 
care to grieving mothers.


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