Exploring coping strategies for perinatal bereaved mothers with loss and its associated factors in public health facilities in Southwest Ethiopia

Abstract

Background: Perinatal death, which includes stillbirth and early neonatal death, represents a profoundly distressing experience for mothers, particularly in low-resource environments where formal bereavement support is frequently inadequate. Despite the significant occurrence of perinatal loss in southwest Ethiopia, there is a lack of evidence regarding maternal coping mechanisms and the factors that influence them. Objective: The purpose of this study was to explore the coping strategies of perinatally bereaved mothers in public health facilities in Southwest Ethiopia, 2025. Methods: A descriptive cross-sectional study based in facilities was carried out from January to June 2025, involving 417 mothers with a history of perinatal death who were receiving maternal health services at public health facilities in Ilubabor and Buno Bedele Zones. Data collection was performed via the culturally adapted Brief Coping Orientation to Problems Experienced Inventory through face-to-face interviews. Multivariate logistic regression analysis was employed to determine the predictors of coping strategies via statistical software (Statistical Package for the Social Sciences 24 version) with a 95% confidence interval and a p < 0.05. Results: The prevalence of positive coping strategies among participants was 55.4% (95% confidence interval: 50.6%–60.2%). Significant factors of positive coping included sufficient social support (adjusted odds ratio = 4.10; 95% confidence interval: 1.91–8.81), maternal education at the secondary level or higher (adjusted odds ratio = 2.42; 95% confidence interval: 1.12–5.21), attendance at antenatal care (adjusted odds ratio = 2.37; 95% confidence interval: 1.05–5.33), high levels of religious involvement (adjusted odds ratio = 2.18; 95% confidence interval: 1.01–4.72), and access to bereavement counselling (adjusted odds ratio = 3.19; 95% confidence interval: 1.38–7.39). Negative coping strategies are often associated with stigma, low educational attainment, and inadequate access to healthcare. Conclusion: More than 44% of mothers resorted to negative coping strategies, highlighting a significant deficiency in bereavement support. Improving social, educational, and health system interventions—especially by incorporating bereavement counselling into public maternal health services—has the potential to enhance maternal mental health outcomes.