Examining stillbirth at the intersection of contextual inequalities in Iran

Although Iran has achieved stillbirth target of Every Newborn Action Plan (≤12 stillbirths per 1000 total births by 2030) at national level, there are still notable contextual inequalities (spatial and socioeconomic) in stillbirth. The purpose of this study is to explain the inequality in stillbirth, using the intersectionality approach that McGibbon proposes in the field of the right to access health care. We used the Iranian Maternal and Neonatal Network (IMAN) for the period of 2013-2020. The indicators extracted from this study showed that mothers who experience several disadvantages at the same time (like non-Iranian mothers who gave birth in the fifth geographic region of Iran (the east), or uninsured mothers over 45 years), experience stillbirth more frequently compared to their counterparts. We came to this conclusion that the intersection of three areas of social determinants of health (maternal education level, type of hospital, type of insurance), the isms (nationality and maternal age) and geographic or spatial contexts (urban-rural residency, the geographical area of birthplace) can create synergy with each other and cause some groups of mothers who belong to the most vulnerable strata of the society to be oppressed more. The main policy suggestion of this research is to reduce stillbirth by considering the intersection of inequalities instead of individual axes of inequality.