title: Addressing Stillbirth in India Must Include Men.
abstract: BACKGROUND
  Millennium Development Goal 4, to reduce child mortality, can only be achieved by reducing stillbirths globally. A confluence of medical and sociocultural factors contribute to the high stillbirth rates in India. The psychosocial aftermath of stillbirth is a well-documented public health problem, though less is known of the experience for men, particularly outside of the Western context. Therefore, men's perceptions and knowledge regarding reproductive health, as well as maternal-child health are important.
  
  
  METHODS
  Key informant interviews (n = 5) were analyzed and 28 structured interviews were conducted using a survey based on qualitative themes.
  
  
  RESULTS
  Qualitative themes included men's dual burden and right to medical and reproductive decision making power. Wives were discouraged from expressing grief and pushed to conceive again. If not successful, particularly if a son was not conceived, a second wife was considered a solution. Quantitative data revealed that men with a history of stillbirths had greater anxiety and depression, perceived less social support, but had more egalitarian views towards women than men without stillbirth experience. At the same time fathers of stillbirths were more likely to be emotionally or physically abusive. Predictors of mental health, attitudes towards women, and perceived support are discussed.
  
  
  CONCLUSIONS
  Patriarchal societal values, son preference, deficient women's autonomy, and sex-selective abortion perpetuate the risk for future poor infant outcomes, including stillbirth, and compounds the already higher risk of stillbirth for males. Grief interventions should explore and take into account men's perceptions, attitudes, and behaviors towards reproductive decision making.
authors.affiliation: a School of Nursing, Loma Linda University , Loma Linda , California , USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Roberts
authors.affiliation: b School of Behavioral Health, Behavioral Health Institute, Loma Linda University , Loma Linda , California , USA.
authors.forename: Susanne
authors.initials: S
authors.lastname: Montgomery
authors.affiliation: c Christian Hospital Mungeli , Mungeli , Chhattisgarh , India.
authors.forename: Gayatri
authors.initials: G
authors.lastname: Ganesh
authors.affiliation: d Summer Institute Intern, School of Behavioral Health, Loma Linda University , Loma Linda , California , USA.
authors.forename: Harinder Pal
authors.initials: HP
authors.lastname: Kaur
authors.affiliation: c Christian Hospital Mungeli , Mungeli , Chhattisgarh , India.
authors.forename: Ratan
authors.initials: R
authors.lastname: Singh
mesh_terms: D000328:Adult; D005220:Fathers / Q000523:psychology*; D005260:Female; D006117:Grief; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D050497:Stillbirth / Q000523:psychology*