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Thesis (Ph.D. (Psychology)) -- University of Limpopo, 2022 / The psychological impact of perinatal death in the form of bereavement has been widely researched especially from the western perspective. The aim of this study was to establish the help-seeking pathways by mothers bereaved through perinatal death from the African perspective. The qualitative research paradigm in particular the phenomenological approach was adopted for the study. Phenomenology is described as an approach that focuses on the study of the lived experiences of individuals within their world. The application of this approach included personal interviews of 20 mothers who have experienced perinatal death at Doctor George Mukhari hospital in Gauteng province. The aim was to establish the help-seeking pathways they adopted to relief their distress, in terms of how they managed their bereavement and the help that they sought to relief their emotional distress. The findings of the study indicated that mothers lacked knowledge about what precipitated the onset of sudden symptoms such as early rupture of membrane, bleeding, lack of foetal movement which finally led to perinatal death. This lack of knowledge led mothers to attribute the cause of perinatal death to various reasons and conclusions such as distance decay, bad roads that delayed their arrival timeously at the hospital for their babies to be saved. Some cited lack of sense of urgency from the medical personnel and shortage of staff, especially doctors. However, they perceived positive social support from their families, spouses and medical professionals as one of the factors that contributed to their level of calmness and ability to bear the pain of loss. However, participants sought alternative help to facilitate clear understanding about what could have caused their babies to die, also how to manage their grief and how to deal with their subsequent pregnancies. Most of the participants benefited from the various healing pathways they chose. There is a need for healthcare system and community support to be more responsive to the plight of bereaved mothers, in reducing the stigma and the self-blame by bereaved mothers by offering support through counseling center. The findings reaffirm that despite the great studies taken in reducing perinatal deaths, there is a need for collaboration between the modern healthcare system and the traditional healthcare practitioners. Furthermore, emphasis v is needed on the preventative measures and training of healthcare practitioners within the maternal and child healthcare system to further reduce the alarming increase of prenatal deaths

En dépit des taux élevés de mortalité infantile dans les populations du passé, les sujets décédés en période périnatale ont longtemps été délaissés dans les travaux anthropologiques et paléoanthropologiques. Alors que les analyses biologiques portant sur les individus adultes intègrent l’étude de la variabilité comme une composante majeure, rares sont celles permettant de replacer un individu décédé en période périnatale dans le cadre de la variabilité individuelle ou populationnelle de cette classe d’âge. Le présent travail se propose ainsi d’investir le sujet de la diversité métrique et non-métrique des sujets décédés entre 22 et 48 semaines d’aménorrhée à partir de l’étude biologique de 116 sujets de trois collections archéologiques (une kerma et deux médiévales et modernes) et d’une collection actuelle virtuelle comportant 364 individus. Un premier axe de recherche caractérise la variabilité des corpus dans ses composantes intra-individuelles, inter-individuelles, populationnelles, ainsi que du point de vue des corrélations à l’âge au décès. Un second axe de recherche vise à identifier des caractères permettant d’estimer l’état de morbidité et de vitalité à la naissance de l’individu, donnée déterminante pour le statut du sujet dans la société. Pour le premier axe, l’étude révèle des différences de conformation selon l’âge au décès et les groupes populationnels, de même que l’existence d’asymétries directionnelles et fluctuantes. Les résultats vont ensuite dans le sens d’une forte proximité biologique pour le groupe kerma, traduisant potentiellement une certaine endogamie, au contraire du groupe médiéval et moderne dont la diversité plus importante pourrait refléter des facteurs socio-géographiques ou séculaires. Le second axe de recherche a permis de souligner que la mécano-sensibilité des régions d’insertion musculaire apparaît comme un nouveau paramètre à considérer pour discerner les sujets ayant survécu à la naissance. L’étude de la collection kerma livre également la première identification en contexte archéologique d’un critère de morbidité spécifique, la côte surnuméraire cervicale. Enfin, le croisement des analyses biologiques et des données archéologiques de la nécropole 8B-51 de l’île de Saï, permet d’appréhender et de discuter les traitements funéraires dévolus à la classe d’âge périnatale au Kerma classique. / Despite the high rates of child mortality in past populations, subjects deceased in perinatal period were often neglected in bioarchaeological and paleoanthropology studies. Unlike biological analysis on adults, investigations on newborns rarely include individual or populational variability comparisons as a major component. In the present work, we will focus on metrical and non-metrical diversity of subject deceased between 22 and 48 amenorrhea weeks, based on the biological study of 116 subjects from three archaeological collections (one kerma and two medieval and modern) and one current virtual collection with 364 individuals. The first research axis characterizes the intra-individual, inter-individual and populational variability, and differences by age at death in both samples. The second line of research aims to identify criteria making it possible to estimate individual morbidity and live birth on dry bones, informations that are needed to understand the child’s position in society. Biological studies reveal for the first research axis shape differences by age at death and populations, as well as the existence of directional and fluctuating asymmetries. Results provide evidences of strong biological proximity in the kerma group, potentially indicating of endogamy. On the contrary, the diversity of the medieval and modern group appears broader and could reflect socio-geographical factors or secular trends. The second line of research reveals the mechanical sensitivity of muscular insertions as a key parameter for tracking of live-born subjects. The study of the kerma collection provides the first archaeological identification of the supernumerary cervical rib, detected as a morbidity criterion in perinatal period. Lastly, crossing of biological and archaeological data on the 8B-51 necropolis provides an interpretative framework for funerary treatments dedicated to the perinatal age group in Classic Kerma.