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Date submitted: 02/07/2019 Date accepted: 02/09/2019 Date published: 27/09/2019 Date open access: 27/12/2019
Abstract
Background: The World Health Organization (WHO), and the Lancet's 2011 and 2016 Stillbirth Series, all released a call to action to reduce stillbirth stigma by 2020. However, there is meagre research regarding the concept of stigma as it relates to those who have experienced a stillbirth. Furthermore, there is currently no tool to measure and define the extent and types of stigma felt by bereaved parents; thus, there is no way to determine if stillbirth stigma is being reduced. Therefore, this study sought to create a stillbirth-stigma scale to measure the extent and type of stigma experienced by bereaved parents to gain a better understanding of its constructs. It is anticipated that this scale can be used as a tool to measure any changes in stillbirth stigma to assess if it is being reduced.
Methods: Items for the initial administration of the stillbirth-stigma scale were developed by adapting existing validated stigma scales, gathering information from existing literature, and consulting end-users. Eighty-three potential scale items were piloted on 100 Australian bereaved parents (94 mothers; six fathers) through an online survey.
Ethics: This study was approved on 5 December 2016 by the University of South Australia Human Research Ethics Committee, protocol number 0000036017.
Results: An exploratory factor analysis identified four factors (perceived devaluation stigma, discrimination, disclosure and selfstigma), with the final structure having good factor structure, internal consistency (a=.77), and reliability (r=.90).
Conclusion: The stillbirth-stigma scale has the potential to measure the extent and type of stigma experienced by bereaved parents. Future assessment needs to be conducted to further validate the scale.
Keywords: Scale-development; stigma; stillbirth; perinatal health; methodology; measurement; psychology; health; midwifery; obstetrics; evidence-based midwifery
Introduction
Stillbirth is a prominent health issue worldwide. The World Health Organization's (WHO) definition of stillbirth is baby born with no signs of life from 28 weeks' gestation and/or a gestational weight of one kilogram (Blencowe et al, 2016). According to this definition, it is estimated that globally more than 2.6 million stillbirths occur each year, which equates to more than 7,000 stillbirths per day (Blencowe et al, 2016). While low income countries shoulder 98% of the burden, Australia was ranked 11th in the world in...