Interpretations of stillbirth.

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.