Table 2.

Qualitative analysis for women response regarding loss of fetus/infant during PMTCT care

Main themes and sub-themes	Frequency (n=15)	Illustrative core idea(s)
Critical delays in care leading to fetal / infant loss
Patient delays in seeking care	2	“I felt weight on the vagina, and I was very tired. I didn’t feel fetal movement for the whole day, day and night. I went to clinic [the following day] and I told a nurse how I felt.”
Provider delays in providing proper clinical decision making	3	“At the clinic they said they couldn’t hear well the fetal heartbeats and also they didn’t know I have twins, until I got to the hospital for delivery.”
Health system delays in facilitating emergency care or transfer	3	“I think the delay in caesarian-section is what caused my baby to drink that water [amniotic fluid].”
Healthcare provider-patient communication
Insufficient information was given to the patient.	9	“The nurse did not tell me the cause of death.” “The doctor told me I had to leave the hospital, even though I was in pain. I was not given any information about my diagnosis or condition. I later delivered at home and the baby died.”
Patient received important information and/or advice from the doctor and developed an understanding of her child’s death.	7	“The doctors told me that cause of death was immaturity of lungs.” “No, there are no any other doubts about death of the baby; it was only due to the heart problem.”
Mothers dealing with and coping with fetal or infant loss
Feelings of sadness, memories, crying, hopelessness	10	“I was deeply hurt, and I cry when I remember.”
Faith-based acceptance and coping. Death of child was part of God’s plan, strength and acceptance from God, thanking God	10	“I am depending on God and I have the ability to accept and endure.” “I have to accept as that is God’s will.”
Support from others: partner, family, friends, clinic staff	7	“My family, especially my mother, play a great role to comfort and encourage me.”
Other strategies for coping	4	“I need to have another baby.”
Signs of depression, suicidal thoughts	3	“I am no longer motivated after the death of my child”
Impact of fetal/infant loss on attitudes toward HIV care
Continuing treatment as usual, not discouraged or deterred, committed to lifelong treatment	12	“This has not discouraged me from taking my medication. Although sometimes I feel worthless, but I have not stopped taking my medicines.”
Death of child created doubt, ambivalence, or challenge in continuing treatment	3	“I feel like going there will remind me a lot, but I will try and go back for HIV care.” “I am still taking my drugs but the death of my child has demoralized me.”