Embracing Our Realities Even in the Face of a Shared Grief
By: Tosin Popoola
Introduction
Among the Yoruba people of Nigeria, pregnancy and perinatal loss are understood and interpreted from the concept of ‘pot and water.’ From the Yoruba worldview, a pregnant woman is like a pot and the pregnancy she is carrying is the water. From this perspective, when Yoruba people want to communicate that a pregnancy resulted into stillbirth, they say ‘omi lo danu, akengbe o fo’, literally translated as ‘only the water has spilled, the pot is still intact.’ There is emphasis on the intactness of the pot because the ultimate tragedy is not the ‘water spillage’ (stillbirth), but that of a broken pot (maternal mortality). The Yoruba cultural interpretation of pregnancy loss mirrors the reality of maternal and child mortality in Nigeria. A woman in Nigeria has 1 in 22 lifetime risk of dying during pregnancy, childbirth or postpartum and this means that up to 58,000 women die from pregnancy-related causes every year (WHO, 2019). As a resulted of the reality of maternal mortality, mothers of stillborn babies are considered to be fortunate to be alive and the central idea of ‘only the water has spilled, the pot is still intact’ analogy is geared towards reminding the mother of the stillborn baby and her family that they still have something to be thankful for despite the loss of a child. In a culture that places so much value on children, this approach to bereavement does not mean a denial of the loss of the child, but rather, an acknowledgement of the choice that their reality presents them. This narrative of stillbirth has many ramifications for the experience of stillbirth, the support that is available and how women themselves want to be supported.
In 2017, I spent six months in Nigeria, a country located in the western part of Africa talking to 20 women who have lost termed third trimester pregnancies to stillbirth. I reflect on my experience of talking with these women about their experience of stillbirth
Process over product
Among the Yoruba people of Nigeria, motherhood is highly revered, and many women look forward to it. This is because motherhood not only confirms special status and respect, it is also a form of empowerment that protects women from the stigma of childlessness and the instability that comes with it. As an illustration, numerous Yoruba proverbs describe motherhood in the following way: iya ni wura iyebiye ti a ko le fi owo ra (a mother is a like a precious gold that no amount of money can buy); orisa bi iya ko si, iya la ba ma a bo (a mother is a god that should always be worshipped). The accolades that have been engrained in the concept of motherhood reflects what women go through to become mothers, but also mothers’ role in the socialisation of children. Yoruba culture strongly believes that a child that grows to become a responsible member of the society reflects the role played by the child’s mother. The unique role that mothers play in children’s socialisation means that pregnancy is not a private experience for the mother, rather, it is a collective experience. When the baby bump becomes visible, people (both close friends and strangers) show their interest in the pregnancy by saying “e ku idura”, literally translated as “greetings for the struggle your body is going through.” From this perspective, it is not hard to imagine that any Yoruba woman whose pregnancy ends in stillbirth would want to be acknowledged for her shot at motherhood despite the outcome. Mothers acknowledged that they appreciated conversations that centre around the pregnancy itself, how the labour started, how they learnt about the death, and plans for subsequent pregnancies, rather than conversations about the child that died. This means that any support that elevates the personhood of the stillborn baby over the motherhood aspirations of the mother will be a culturally unsafe care for a Yoruba woman.
If stillbirth affects the mind, how will memorabilia help?
“Ogbe okan ni” (it is an intractable wound on the mind)
The mothers likened stillbirth to an intractable wound on the mind and because of this, they frowned at any attempt to represent or symbolize their loss with any physical object. The mothers claimed that it is “maternal instinct to think what if my baby was alive, he or she would have been like this or that.” As a result, all the mothers turned down the mementoes meant to memorialize their loss, asking why they should keep an object when “children who are of the same age group as their own stillborn babies” mentally triggers their memory on a continuous basis. Mothers also worry that keeping mementoes, which is clearly a deviation from cultural norms will expose their grief to labels associated with medical and cultural pathologies, a scenario that they even dread more because of the stigma associated with mental derangement. One of the women acknowledged that “it is impossible to forget but keeping something as remembrance is not part of Yoruba culture. When you do that, the wound in your heart will not heal”. This means that before handing a mother memento, it is important to ascertain whether it facilitates conversations with others about her loss and whether it impedes or facilitates a mother’s grief.
Conclusion
It is important for those providing support for mothers of stillborn babies that just like all stillbirths cannot be medically or scientifically explained, not all guidelines can safely account for how a mother can best be supported after stillbirth. This means that a guideline that recommends calling a stillborn baby by ‘name’ as best practice may not be culturally safe for mothers whose cultural practice is to wait certain days after birth before naming a child.
References
World Health Organisation (2019). Maternal health in Nigeria: generating information for action. Retrieved from https://www.who.int/reproductivehealth/maternal-health-nigeria/en/
About Tosin Popoola
Tosin Popoola is a Nursing Lecturer at the Victoria University of Wellington’s School of Nursing, Midwifery and Health in New Zealand. He is a registered nurse and midwife and has a PhD in Nursing.
Email: Tosin.Popoola@vuw.ac.nz