(In)visibilising pregnancy loss in Southern Malawi.

IF 1.8 3区 医学 Q2 FAMILY STUDIES Culture, Health & Sexuality Pub Date : 2024-11-01 Epub Date: 2024-03-12 DOI:10.1080/13691058.2024.2324001
Bregje de Kok, Marion Chirwa Kajombo, Priscilla Matinga, Blessings Kaunda
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Abstract

Miscarriages, stillbirths and neonatal deaths have received limited attention in global health programmes and research, even though pregnancy loss is common, traumatic and stigmatised. This paper seeks to illuminate lived experiences of pregnancy loss in southern Malawi, drawing on findings from semi-structured interviews and focus groups with women who have experienced loss, health professionals and community members, and observations of maternity care. Combining thematic and discourse analysis, we show how societal and medical discourses frame women as responsible for (failed) reproduction, and restrict possibilities to speak about, and respond to, loss. Some accounts and (care) practices invisibilise loss and associated suffering. However, invisibilisation may also be intended as support, and underscores rather than denies the social significance of parenthood. Other accounts (e.g. women emphasising faith and acceptance) constitute moral survival strategies to avoid the acquisition of a 'spoiled identity'. We conclude that societal and medical discourses of loss enact stigmatised, subaltern subject positions for women experiencing pregnancy loss, create social suffering, and amount to a form of structural violence. Programmes and interventions should change these discourses.

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(使马拉维南部的妊娠损失(不)透明化。
流产、死胎和新生儿死亡在全球健康计划和研究中受到的关注有限,尽管妊娠损失是常见的、创伤性的和耻辱性的。本文通过对经历过妊娠损失的妇女、医疗专业人员和社区成员进行半结构式访谈和焦点小组讨论,并对产科护理进行观察,试图阐明马拉维南部妊娠损失的生活经验。结合主题分析和话语分析,我们展示了社会和医疗话语是如何将妇女定格为(失败的)生育责任人,并限制了她们谈论和应对失子的可能性。一些说法和(护理)实践将损失和相关痛苦隐蔽化。然而,这种淡化也可能是一种支持,强调而不是否认为人父母的社会意义。其他一些说法(如妇女强调信仰和接受)则构成了避免获得 "被宠坏的身份 "的道德生存策略。我们得出的结论是,社会和医学的失落论述为经历妊娠失落的妇女确立了污名化的、次等的主体地位,造成了社会痛苦,相当于一种结构性暴力。计划和干预措施应改变这些话语。
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来源期刊
CiteScore
4.60
自引率
4.50%
发文量
80
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