[“If you don’t push, you’ll kill your child!” Midwives and mothers faced with perinatal death (Togo)]

The latest global reports show that in 2016, 2.6 million children died worldwide during their first month of birth. Also, the proportion of neonatal deaths among the deaths of children under 5 increased between 1990 and 2015: from 26% in 1990 to 35% in 2015 [1].

An anthropological study in public health and home-based structures in north Togo (Savanes region) allowed us to observe and perform a clinical ethnography of different perinatal death situations.

The nursing staff, consider the mother as responsible: She didn't come to the hospital early; she was ill but did not get treated or she was late for the expulsion leaving the newborn suffocating. The health care staff is rarely called into question in the face of such a situation. In addition to the guilt of grieving mothers, these tragic situations are in most cases erased as having never occurred by the nursing staff and also by the family: silence and many things left unsaid surround these deaths.

This study shows that we need to initiate death audits in the maternity wards in order to improve care for mothers and newborns.