Navigating stillbirth in low- and middle-income countries: A systematic review of maternal experiences

Background Cultural beliefs, social expectations, and the quality of maternity care shape how women perceive stillbirth, cope with loss, and navigate their identity after bereavement. Understanding these experiences is essential for improving emotional support and respectful care.Objective To synthesise qualitative evidence regarding the psychosocial impact of stillbirth on women in LMIC contexts, and to examine how cultural, social, and healthcare factors shape women's perceptions and experiences of stillbirth.Methods A systematic search was conducted in February 2026 across the following databases: PubMed, Scopus, ScienceDirect, and EBSCO. Eligible studies were those that employed qualitative or mixed methods. Methodological quality was assessed using a standardised qualitative appraisal tool. Data were synthesised using thematic analysis.Findings Twenty-five studies across fourteen countries met the inclusion criteria. Five themes were identified: (1) cultural spiritual attributions of responsibility, (2) supportive versus isolating interactions, (3) silenced grief and social expectations, (4) from compassion to mistreatment: the spectrum of health worker influence, and (5) the crisis of identity in the disrupted journey of motherhood. These themes reveal complex emotional responses shaped by blame, stigma, social expectations, and experiences within the health system.Discussion Women's experiences of stillbirth are heavily influenced by culturally grounded interpretations of loss and by the quality of interpersonal and institutional support. These factors affect help-seeking, grieving, and future engagement with maternity services.Conclusion Improving respectful communication, strengthening emotional support within maternity care, and addressing stigma through community-based approaches are essential to support women experiencing stillbirth in diverse cultural settings.