Population based cohort study of fetal deaths, and neonatal and perinatal mortality at term within a Somali diaspora

Incidence of stillbirth among women with different risk profiles in Stockholm 2001-2020: a repeated cross-sectional study

INTRODUCTION

The incidence of stillbirth in Sweden has started to decline. However, some comparable high-income countries in Europe have an even lower incidence, indicating a potential for further reduction. The aim of our study was to investigate how the incidence of stillbirth for singleton pregnancies has changed over the past two decades in the Stockholm Region in different groups of women to detect the groups at highest risk.

MATERIAL AND METHODS

This was a repeated cross-sectional study with data from the Stockholm Stillbirth Database and the Pregnancy Register including all cases of stillbirth in Stockholm in singleton pregnancies between 2001 and 2020, in total 1804 stillbirths. The time period was divided into four equal groups and the incidence of stillbirth was compared between the groups.

RESULTS

The overall incidence of stillbirth in the Stockholm Region has decreased from 3.8/1000 births in 2001-2005 to 2.9/1000 births in 2016-2020 (P-value <0.001). In most of the groups studied, the incidence decreased, but among women originating from sub-Saharan Africa the incidence significantly rose from 7.9/1000 births in 2001-2005 to 10.1/1000 births in 2016-2020 (P-value 0.025). In this group, stillbirth occurred prematurely to a higher extent and the women were more likely to be multiparous.

CONCLUSIONS

The incidence of stillbirth in the Stockholm Region has declined. However, among women originating from sub-Saharan Africa the incidence was significantly higher compared with women originating from other regions and it is still rising. More research is needed to understand why this group is at higher risk and how to monitor their pregnancies to decrease this risk.

Somali Refugee Women's Experiences and Perceptions of Western Health Care

INTRODUCTION

The purpose of this study was to explore Somali refugee women's experiences and perceptions of Western health care in the United States. This study took place in the Midwestern region of the United States.

METHODOLOGY

This qualitative descriptive study collected data from 15 participants through in-depth interviews.

RESULTS

Six themes emerged: (a) communication and resource provision, (b) participatory decision-making, (c) provider attitudes toward cultural practices, (d) understanding the U.S. health care system, (e) resistance to Western health care and, (f) religious beliefs.

DISCUSSION AND CONCLUSION

Accounts of the women in this study ran the gamut from positive views to those that were more critical and replete with complaints about Western health care providers and the system. Somali refugee women need culturally competent health care providers who provide sensitive care, offer resources, and involve the women in decision-making about their care.