The measurement of historical trends in fetal mortality in England and Wales

This paper critically discusses recent attempts to estimate long-term trends in the stillbirth rate for England and Wales. It assesses the available historical evidence for the level of late-fetal mortality, drawing especially on examples from Norway, Sweden, and Denmark. A theoretical fetal–infant life table for a high-mortality population is also outlined as a means of analysing the relationship between segments of the conception-to-first-birthday mortality curve. Finally, new estimates of the stillbirth rate for England and Wales are proposed, based on variations in the early neonatal and maternal mortality rates during the 1930s. These estimates are substantially lower than the earlier estimates and are more in keeping with the available evidence from northern Europe. The implications of the revised estimates for interpretations of historical changes in mortality patterns are also considered.     

When a Baby Dies: Ambiguity and Stillbirth

ABSTRACT

Stillbirth, or sudden intrauterine death, is in many ways an invisible death. A stillborn infant is one mature enough developmentally to have lived outside the womb but for some reason, or perhaps multiple reasons, was born dead. Stillborn infants are often demarcated from other types of child death and are rarely legitimized as a real loss. When a baby is stillborn, mothers, fathers, surviving siblings, and grandparents may struggle for years to find answers to a series of complex and inherently unanswerable questions. The family members' profound feelings of grief and ambiguity loss are borne in a social environment that denies this reality because the child's death was invisible to most of the world. Boss's framework for understanding ambiguous loss proves quite helpful in thinking about stillbirth.     

Long-term Mortality Patterns in Chinese History: Evidence from a Recorded Clan Population

This paper addresses the emerging interest in the relationship between homeostatic models and demographic transition theory. Firstly, it considers the nature of fertility measurement and concepts. The paper then goes on to examine evidence from pre-transitional societies in which demographic regimes have been most thoroughly studied, summarizing what is known about their character. The nature and current status of homeostatic theories in demography and the institutional supports of pre-transitional regimes are considered. The implications of the findings on pre-transitional populations for transition theory are then discussed. The paper concludes with suggestions for ways in which studies of transition within a framework of homeostatic regimes could be developed.     

Facilitators and barriers to substance-free pregnancies in high-income countries: A meta-synthesis of qualitative research

BackgroundPrevious studies have associated substance use (alcohol, illicit drugs and smoking) to negative pregnancy outcomes, including higher risk of stillbirth.AimThis study aims to identify facilitators and barriers reported by women to remain substance free during pregnancy.MethodsA systematic search was conducted in six databases from inception to March 2019 and updated in November 2020. Qualitative studies involving pregnant or post-partum women, from high-income countries, examining women’s experiences of substance use during pregnancy were eligible. Meta-ethnography was used to facilitate this meta-synthesis.FindingsTwenty-two studies were included for analysis. Internal barriers included the perceived emotional and social benefits of using substances such as stress coping, and the associated feelings of shame and guilt. Finding insensitive professionals, the lack of information and discussion about risks, and lack of social support were identified as external barriers. Furthermore, the social stigma and fear of prosecution associated with substance use led some women to conceal their use. Facilitators included awareness of the health risks of substance use, having intrinsic incentives and finding support in family, friends and professionals.DiscussionPerceived benefits, knowledge, experiences in health care settings, and social factors all play important roles in women’s behaviours. These factors can co-occur and must be considered together to be able to understand the complexity of prenatal substance use.ConclusionIncreased clinical and community awareness of the modifiable risk factors associated with substance use during pregnancy presented in this study, is necessary to inform future prevention efforts.     

Paternal Age and Child Death: The Stillbirth Case

Previous research has shown an association between paternal age and neonatal mortality controlling for age of mother and other confounding factors. As this association is possibly of a biological nature, one would also expect to find a significant relationship between paternal age and fœtal mortality,stillbirth in particular. The present research is based on a Czech individual data set for the period 1986–1990. The risk of stillbirth is examined using logistic regression, taking account of both parental ages, sex of the fœtus, birth order, prematurity, and education of parents. It is shown that, in this data set, there is a significant relation between age of father and risk of stillbirth. This revised version was published online in July 2006 with corrections to the Cover Date.     

Stillbirth and the Couple: A Gender-Based Exploration

ABSTRACT

The stillbirth of a baby occurs in about 1 in 110 families yearly. Yet, little is understood about the ways in which grieving mothers and fathers experience the baby's death. This study is intended to explore the ways in which bereaved parents perceive and cope with the death of their baby and how the baby's death affects them both individually and as a couple. Respondents answered open-ended questions about their experiences. Results suggest that mothers and fathers grieve individually and collectively, struggling to find meaning in their losses. Responses to a baby's death may depend, in part, on the parent's gender, as well as on the individual's locus of control, couple and family cohesion, the degree of attachment to the baby, and social support. The death of a baby may create conflict in a marital dyad, yet many couples also experience a greater sense of closeness. A therapeutic relationship that is nonhierarchical and egalitarian, focusing on “keeping the therapist close to the experience of each partner” (Vatcher &; Bogo, 2001 Vatcher , C. , &; Bogo , M. ( 2001 ). The feminist/emotionally focused therapy practice model: An integrated approach for couple therapy . Journal of Marital and Family Therapy , 27 ( 1 ), 69 – 83 .[Crossref], [PubMed], [Web of Science ®] , [Google Scholar], p. 76) may offer a place where the marital relationship can flourish after such a tragic experience.