Stigmas Surrounding Postpartum Maternal Health
Isha Gupta
June 2024
Welcoming new life into the world can be a major life milestone and the start of a new chapter. Socio-cultural beliefs and stigmas can influence public perceptions and attitudes toward new mothers. Stigmas surrounding postpartum maternal health can be diverse and affect women’s health and well-being.
Stillbirth
A stillbirth can be a stressful and difficult experience for parents. Although improvements have been made in maternity healthcare services overall, stillbirths are still relatively prevalent. Recent estimates suggest that there are more than 2.7 million stillbirths in the world each year.[1] Stillbirths can significantly impact the mental health and emotional well-being of parents, often leading to depression, post-traumatic stress disorder, and suicidal ideation.[1] Research has also found that women who had a stillbirth may feel embarrassed and guilty about their post-pregnant bodies, and this negative body image can decrease their sexual activity and pleasure.[1]In addition, many women blame themselves or are blamed by their partner and family, for their stillbirth. The stigma surrounding stillbirths can be so severe, especially in low and middle-income countries, where women who had a stillbirth are perceived as being under the spell of evil spirits, and women are also accused of getting abortions. Furthermore, some women have been divorced by their partners, got physically abused, and were even forced to leave their villages.[1] Effectively supporting parents in diverse ways can help them develop resilience and support their mental health. For instance, researchers found that providing parents the opportunity to see their baby, say goodbye, and make final memories helped decrease anxiety and sleep disorders, along with promoting coping and healing.[1] Additionally, along with addressing taboos, it is beneficial for bereavement care to be religiously and culturally sensitive. Moreover, conducting further research, especially on the diverse impacts of stillbirths can help increase knowledge and understanding about the complexity of this grief and loss.[1]
C-section
A Cesarean section (C-section) is essential when vaginal birth poses risks to the mother or her baby, yet a C-section can be accompanied by stigma. The stigma can be influenced by vaginal deliveries being exceedingly promoted while implying C-sections to be unnatural and abnormal.[2] As a result, frequently, women who are unable to have vaginal deliveries are labeled as weak and lazy.[3] This stigma can often come from loved ones, particularly mother figures or other women in one’s immediate family, which can contribute to the peer pressure of vaginal birth.[3] Continuous and improved tools for science communication, including accurate social media outlets, can be utilized to raise awareness about the importance of C-sections when vaginal deliveries are unsafe.[2] Such maternal health communication strategies must be comprehensive, factual, and accessible to diverse members of the public to help address negative perceptions toward C-sections.
Postpartum Bleeding
In many cultures, there are negative connotations associated with bleeding during and after childbirth. These include misconceptions that postpartum bleeding is contagious, and that evil spirits cause it to punish new mothers for ignoring social rules or past mistakes.[4] Stigmas can place significant restrictions on new mothers’ lives. For example, in some communities of Nepal, women are isolated and confined in cowsheds and huts, both during menstrual bleeding and immediately after childbirth, because they are considered impure, unclean, and untouchable.[5, 6] Along with affecting women’s physical and mental health, restrictions can pose a threat to their lives due to unsafe living conditions. Furthermore, stigmas could contribute to disinformation and prevent excessive blood loss, known as postpartum hemorrhage, from being taken seriously. Postpartum hemorrhage is crucial to be aware of as it is a leading cause of maternal mortality globally.[4] A collective effort, including policymakers, researchers, public health workers, medical professionals, and community members must be made to ensure that the public has factual information about postpartum bleeding. Moreover, essential resources including access to medicines and supplies for management must be ensured.[4]
Breastfeeding
Breastfeeding is an important component of maternal and child health given that it offers a variety of benefits to both new mothers and their babies. Infants who are breastfed have a lower risk of diverse health concerns such as diarrhea, vomiting, respiratory infections, ear infections, cavities, and infant mortality.[7] By the same token, breastfeeding can lower mothers’ risks of concerns such as breast cancer and cardiovascular disease, while helping to reduce postpartum bleeding.[7] However, women may face stigma, especially in public settings, where women are often informed to stop breastfeeding or leave. The embarrassment and fear of being stigmatized can cause women to give up breastfeeding altogether, especially when it restricts social interactions. Cultural perceptions, including the over-sexualization of female breasts as opposed to emphasis on their nurturing function of breastfeeding, further contribute to this stigma.[8] Knowledge about the benefits breastfeeding offers for both the baby and the mother needs to be increased to ensure information about health is accessible and promote more positive attitudes towards breastfeeding. Furthermore, promoting policies that support women’s health such as maternity leave can help ensure that women are able to breastfeed safely and conveniently while they take care of their infants.
There are diverse stigmas and taboos new mothers might encounter. Social and cultural perceptions can influence awareness of maternal health and how new mothers are treated. Addressing harmful stigmas is important to supporting and safeguarding women’s health and wellness postpartum.
References
[1] Burden, C., Bradley, S., Storey, C., Ellis, A., Heazell, A. E. P., Downe, S., Cacciatore, J., & Siassakos, D. (2016, January 19). From grief, guilt pain and stigma to hope and pride – a systematic review and meta-analysis of mixed-method research of the psychosocial impact of stillbirth. BioMed Central. https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-016-0800-8
[2] Vazquez Corona, M., Betrán, A. P., & Bohren, M. A. (2022). The portrayal and perceptions of cesarean section in Mexican media Facebook pages: a mixed-methods study. Reproductive health, 19(1), 49. https://doi.org/10.1186/s12978-022-01351-8
[3] Udobang, W. (2018, December 17). Silence about C-sections: Nigeria has some of the highest infant and maternal mortality rates in the world, in part, because of taboos over Caesarean sections. Sage Journals. https://journals.sagepub.com/doi/full/10.1177/0306422018819324
[4] Akter, S., Forbes, G., Vazquez Corona, M., Miller, S., Althabe, F., Coomarasamy, A., Gallos, I. D., Oladapo, O. T., Vogel, J. P., Lorencatto, F., & Bohren, M. A. (2023). Perceptions and experiences of the prevention, detection, and management of postpartum haemorrhage: a qualitative evidence synthesis. The Cochrane database of systematic reviews, 11(11), CD013795. https://doi.org/10.1002/14651858.CD013795.pub2
[5] Sommer, M., Phillips-Howard, P. A., Mahon, T., Zients, S., Jones, M., & Caruso, B. A. (2020, May 1). Beyond menstrual hygiene: addressing vaginal bleeding throughout the life course in low and middle-income countries. BMJ Journals. https://gh.bmj.com/content/2/2/e000405?source=post_elevate_sequence_page———————– —-
[6] Thakuri, D. S., Thapa, R. K., Singh, S., Khanal, G. N., & Khatri, R. B. (2021). A harmful religio-cultural practice (Chhaupadi) during menstruation among adolescent girls in Nepal: Prevalence and policies for eradication. PloS one, 16(9), e0256968. https://doi.org/10.1371/journal.pone.0256968
[7] Cleveland Clinic. (2023, July 17). Benefits of Breastfeeding. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/15274-benefits-of-breastfeeding
[8] The Surgeon General’s Call to Action to Support Breastfeeding. (2011). Barriers to Breastfeeding in the United States. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK52688/
