Expectations and rights of bereaved parents

We may have concerns that we believe are related to our rights, but they are not considered as rights by either law or policy. However, this does not mean we cannot advocate for these to be considered as rights as we seek to facilitate change.

Respectful bereavement care is the support given to benefit bereaved parents to help them deal with the emotional and practical challenges experienced after stillbirth. At the hospital, this is usually facilitated by providers. Considering the components of respectful bereavement care (see the box below) can help clarify what parents bereaved by stillbirths are entitled to at the hospital.

The above is adapted from the Respectful Bereavement Care curriculum prepared by Still A Mum.

• In addition to the stillbirth-related rights that are granted to women and families by Kenyan law and policy, there are also global rights and policies that are relevant for families bereaved by stillbirth in every country. Knowing about these global rights and policies can help families to be aware of, and push for, better care during and after stillbirth.
• In every country, women have the right to available, accessible, acceptable, and good quality healthcare. Assuring this set of rights can help to prevent stillbirths and to ensure families receive respectful bereavement care when stillbirth happens.
• Two main global documents reflect these rights:
  • In 2014, the World Health Organization issued a statement for respectful maternity care calling for the protection of a woman’s “right to dignified, respectful health care” and “ending disrespect and abuse during childbirth”.
  • In 2018, the updated Respectful Maternity Care Charter was published; it states that high-quality maternity care supports and upholds the dignity of both the mother and the newborn. The Charter sets out how these human rights should be guaranteed in pregnancy and childbirth care.
• In 2016, a key series on stillbirth was published in the global medical journal, The Lancet, which emphasized that this global rights framework means that supportive, respectful care in pregnancy and childbirth, including after a stillbirth, is a core part of high quality healthcare for all women.
• To be high quality, such care must also be context-specific and culturally acceptable, according to the best available evidence globally about what matters for families. For example, parents in all countries should be given the option to hold a baby who has died, yet the bodies of stillborn babies in many countries are often disposed of without any recognition, name, clothes, or funeral.
• Women (and all people) have fundamental human rights, including “the highest attainable standard of physical and mental health”.  Respectful bereavement care is a part of this. It includes an acknowledgment of stillbirth and help for families to respond in their own ways.
• Empowerment of parents is critical to transforming these global rights into reality, through education and awareness raising, equitable decision making, woman-focused care, and greater access to resources. In fact, realizing global rights can improve health outcomes, including the prevention of stillbirths and appropriate respectful care for parents after stillbirth. Health workers’ and communities’ norms of complacency and fatalism related to stillbirth are common roadblocks.
• Ultimately, acknowledgment of women’s rights to respectful care during and after childbirth can support the development of a common understanding of, and commitment to, respectful care during and after stillbirth as well.
  

  The content of this Fact Sheet is paraphrased from de Bernis L, Kinney MV, Stones W, ten Hoope-Bender P, Vivio D, Leisher SH, et al. Stillbirths: ending preventable deaths by 2030. The Lancet. 2016;387(10019):703-16

• You have learned a bit about some of the rights you have related to stillbirth care, and also about some of the policies and expectations that relate to this care.
• You also probably know from experience that such care is not always provided. It can be helpful to consider the possible roadblocks to different elements of respectful bereavement care. As you review the fact sheet below, think about how you might work to overcome some of these roadblocks.