{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T14:43:59Z","timestamp":1792248239784,"version":"4.4.0"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research","doi-asserted-by":"publisher","award":["NHRP-2024-0000065\/F1"],"award-info":[{"award-number":["NHRP-2024-0000065\/F1"]}],"id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001411","name":"Indian Council of Medical Research","doi-asserted-by":"publisher","award":["NHRP-2024-0000065\/F1"],"award-info":[{"award-number":["NHRP-2024-0000065\/F1"]}],"id":[{"id":"10.13039\/501100001411","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Globally, stillbirth is a silent yet significant contributor to perinatal mortality. India has several national maternal and child health programs, yet, the stillbirths remain poorly reviewed, subject to suboptimal surveillance, are under-reported, and often absent from many programmatic priorities. This study aimed to explore the pathways, delays leading to stillbirths and continuum of care in postpartum phase among affected women in a rural district of North India using a social autopsy tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This qualitative study was a component of an ongoing implementation research to reduce stillbirth in Palwal district of Haryana. In-depth interviews were conducted with 25 women who had experienced stillbirths using a specially designed social autopsy tool. Additionally, five healthcare providers were interviewed for getting a holistic insight on pathway leading to stillbirth. Thematic analysis was performed using NVivo 16 software, and both deductive (Three Delays Model framework) and inductive approaches were applied to identify delays and contextual factors influencing care-seeking, and postpartum experiences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The pathways identified as contributor stillbirths were: (i) low utilization of antenatal and delivery care, driven by cultural beliefs, low perceived risk, and gendered power dynamics; (ii) delays in accessing care due to poor transport, restrictive social norms, and infrastructural gaps; (iii) poor quality of care, characterized by disrespectful treatment, inappropriate referrals, and inadequate intrapartum management. Additionally, a complete absence of postpartum follow-up, grief support, or mental health care was found, reflecting a neglected dimension of postpartum maternal care following stillbirths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Stillbirths in this setting are the consequence of interlinked socio-cultural, health system, and gendered vulnerabilities. The implications of stillbirths extended beyond immediate consequences to include enduring mental health and social impacts, ultimately undermining women\u2019s confidence, well-being and preparedness for future pregnancies. There is an urgent need to integrate stillbirth reporting, respectful maternity care, and post-loss psychosocial support within India\u2019s maternal health programs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      The primary implementation research was registered prospectively in the Clinical Trial Registry of India (CTRI): CTRI\/2024\/07\/069796 [\n                      <jats:bold>Registered on: 02\/07\/2024<\/jats:bold>\n                      ].\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0347994","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T17:28:27Z","timestamp":1778693307000},"page":"e0347994","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Exploring pathways leading to stillbirths and gaps in postnatal care among affected women in a rural north Indian district: A qualitative study using the social autopsy lens"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4574-580X","authenticated-orcid":true,"given":"Barsha","family":"Gadapani Pathak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Maurya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shruti","family":"Bisht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranay","family":"Vats","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9754-5637","authenticated-orcid":true,"given":"Reema","family":"Mukerjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinod Kumar","family":"Anand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarmila","family":"Mazumder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"pone.0347994.ref001","doi-asserted-by":"crossref","first-page":"100253","DOI":"10.1016\/j.lansea.2023.100253","article-title":"Adverse birth outcomes among women with \u2018low-risk\u2019 pregnancies in India: findings from the Fifth National Family Health Survey, 2019-21","volume":"15","author":"A Tandon","year":"2023","journal-title":"Lancet Reg Health Southeast Asia"},{"key":"pone.0347994.ref002","volume-title":"A neglected tragedy: the global burden of stillbirths","author":"UN Inter-agency Group for Child Mortality Estimation","year":"2020"},{"key":"pone.0347994.ref003","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s12884-016-0800-8","article-title":"From grief, guilt pain and stigma to hope and pride - 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