Attitudes and perspectives of autopsy after a stillbirth: a qualitative study of mothers in Ghana

Abstract

Introduction Stillbirth remains a major global health challenge, with approximately 2.6 million cases reported annually, 98% of which occur in low- and middle-income countries. Autopsy after stillbirth is essential for understanding the underlying causes and informing preventive strategies. In Ghana, autopsies after stillbirth are rarely offered, and many families decline the option even when available. However, research on postmortem uptake in Ghana and sub-Saharan Africa remains limited. This study aimed to explore the perspectives and perceptions of bereaved mothers regarding autopsy after stillbirth in Ghana. Methods A qualitative exploratory design was employed to examine mothers’ perspectives on autopsy after stillbirth at the Korle Bu Teaching Hospital between January 2020 and June 2021. Participants were identified through hospital labour and delivery records. Convenience sampling was used to recruit mothers for in-depth interviews until data saturation was achieved. Fifteen (15) mothers were interviewed in English. The interviews were transcribed verbatim and analysed using thematic analysis. Results The desire for emotional resolution and preventive value was as a key motivating factor for mothers who consented or indicated willingness to consent to autopsy. Many participants expressed that understanding the cause of stillbirth would provide closure and inform precautionary measures for future pregnancies. On the other hand, mistrust in healthcare personnel, financial constraints, assumptions about the cause of death, and perceived irrelevance of autopsy influenced decisions to decline autopsy after still birth. Cultural norms surrounding death also shaped perceptions, with some mothers viewing autopsy as intrusive once life was considered irreversibly lost. Communication gaps and limited knowledge regarding the availability and purpose of autopsy further contributed to low uptake. Discussion Autopsy after stillbirth uptake in Ghana is shaped by emotional, cultural, financial, and systemic factors. Strengthening provider–parent communication, addressing financial barriers, and integrating culturally sensitive bereavement counseling into post-stillbirth care may improve informed decision-making and enhance efforts to prevent future stillbirths.