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"These are not good things for other people to know": How rural Tanzanian women's experiences of pregnancy loss and early neonatal death may impact survey data quality

Author

Listed:
  • Haws, Rachel A.
  • Mashasi, Irene
  • Mrisho, Mwifadhi
  • Schellenberg, Joanna Armstrong
  • Darmstadt, Gary L.
  • Winch, Peter J.

Abstract

Little research in low-income countries has compared the social and cultural ramifications of loss in childbearing, yet the social experience of pregnancy loss and early neonatal death may affect demographers' ability to measure their incidence. Ninety-five qualitative reproductive narratives were collected from 50 women in rural southern Tanzania who had recently suffered infertility, miscarriage, stillbirth or early neonatal death. An additional 31 interviews with new mothers and female elders were used to assess childbearing norms and social consequences of loss in childbearing. We found that like pregnancy, stillbirth and early neonatal death are hidden because they heighten women's vulnerability to social and physical harm, and women's discourse and behaviors are under strong social control. To protect themselves from sorcery, spiritual interference, and gossip--as well as stigma should a spontaneous loss be viewed as an induced abortion--women conceal pregnancies and are advised not to mourn or grieve for "immature" (late-term) losses. Twelve of 30 respondents with pregnancy losses had been accused of inducing an abortion; 3 of these had been subsequently divorced. Incommensurability between Western biomedical and local categories of reproductive loss also complicates measurement of losses. Similar gender inequalities and understandings of pregnancy and reproductive loss in other low-resource settings likely result in underreporting of these losses elsewhere. Cultural, terminological, and methodological factors that contribute to inaccurate measurement of stillbirth and early neonatal death must be considered in designing surveys and other research methods to measure pregnancy, stillbirth, and other sensitive reproductive events.

Suggested Citation

  • Haws, Rachel A. & Mashasi, Irene & Mrisho, Mwifadhi & Schellenberg, Joanna Armstrong & Darmstadt, Gary L. & Winch, Peter J., 2010. ""These are not good things for other people to know": How rural Tanzanian women's experiences of pregnancy loss and early neonatal death may impact survey data quality," Social Science & Medicine, Elsevier, vol. 71(10), pages 1764-1772, November.
  • Handle: RePEc:eee:socmed:v:71:y:2010:i:10:p:1764-1772
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    References listed on IDEAS

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    1. Silberschmidt, Margrethe & Rasch, Vibeke, 2001. "Adolescent girls, illegal abortions and "sugar-daddies" in Dar es Salaam: vulnerable victims and active social agents," Social Science & Medicine, Elsevier, vol. 52(12), pages 1815-1826, June.
    2. Renne, Elisha P., 1996. "The pregnancy that doesn't stay: The practice and perception of abortion by Ekiti Yoruba women," Social Science & Medicine, Elsevier, vol. 42(4), pages 483-494, February.
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    1. de Kok, B.C., 2019. "Between orchestrated and organic: Accountability for loss and the moral landscape of childbearing in Malawi," Social Science & Medicine, Elsevier, vol. 220(C), pages 441-449.
    2. Emily Smith-Greenaway & Christie Sennott, 2016. "Death and Desirability: Retrospective Reporting of Unintended Pregnancy After a Child’s Death," Demography, Springer;Population Association of America (PAA), vol. 53(3), pages 805-834, June.
    3. Helleringer, Stephane & Liu, Li & Chu, Yue & Rodrigues, Amabelia & Fisker, Ane Baerent, 2020. "Biases in Survey Estimates of Neonatal Mortality: Results from a Validation Study in Urban Areas of Guinea-Bissau," SocArXiv qx2kn, Center for Open Science.
    4. Rink, Anselm & Wong-Grünwald, Ramona, 2017. "How effective are HIV behaviour change interventions? Experimental evidence from Zimbabwe," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 9(3), pages 361-388.
    5. Suzanne O. Bell & Mary E. Fissell, 2021. "A Little Bit Pregnant? Productive Ambiguity and Fertility Research," Population and Development Review, The Population Council, Inc., vol. 47(2), pages 505-526, June.
    6. Stéphane Helleringer & Li Liu & Yue Chu & Amabelia Rodrigues & Ane Barent Fisker, 2020. "Biases in Survey Estimates of Neonatal Mortality: Results From a Validation Study in Urban Areas of Guinea-Bissau," Demography, Springer;Population Association of America (PAA), vol. 57(5), pages 1705-1726, October.
    7. Anselm Rink & Ramona Wong-Grünwald, 2017. "How effective are HIV behaviour change interventions? Experimental evidence from Zimbabwe," Journal of Development Effectiveness, Taylor & Francis Journals, vol. 9(3), pages 361-388, July.

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