scholarly journals “Even though they insult us, the delivery they give us is the greatest thing”: a qualitative study contextualizing women’s experiences with facility-based maternal health care in Ethiopia

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Ashley Hagaman ◽  
Humberto Gonzalez Rodriguez ◽  
Clare Barrington ◽  
Kavita Singh ◽  
Abiy Seifu Estifanos ◽  
...  

Abstract Background Globally, amidst increased utilization of facility-based maternal care services, there is continued need to better understand women’s experience of care in places of birth. Quantitative surveys may not sufficiently characterize satisfaction with maternal healthcare (MHC) in local context, limiting their interpretation and applicability. The purpose of this study is to untangle how contextual and cultural expectations shape women’s care experience and what women mean by satisfaction in two Ethiopian regions. Methods Health center and hospital childbirth care registries were used to identify and interview 41 women who had delivered a live newborn within a six-month period. We used a semi-structured interview guide informed by the Donabedian framework to elicit women’s experiences with MHC and delivery, any prior delivery experiences, and recommendations to improve MHC. We used an inductive analytical approach to compare and contrast MHC processes, experiences, and satisfaction. Results Maternal and newborn survival and safety were central to women’s descriptions of their MHC experiences. Women nearly exclusively described healthy and safe deliveries with healthy outcomes as ‘satisfactory’. The texture behind this ‘satisfaction’, however, was shaped by what mothers bring to their delivery experiences, creating expectations from events including past births, experiences with antenatal care, and social and community influences. Secondary to the absence of adverse outcomes, health provider’s interpersonal behaviors (e.g., supportive communication and behavioral demonstrations of commitment to their births) and the facility’s amenities (e.g., bathing, cleaning, water, coffee, etc) enhanced women’s experiences. Finally, at the social and community levels, we found that family support and material resources may significantly buffer against negative experiences and facilitate women’s overall satisfaction, even in the context of poor-quality facilities and limited resources. Conclusion Our findings highlight the importance of understanding contextual factors including past experiences, expectations, and social support that influence perceived quality of MHC and the agency a woman has to negotiate her care experience. Our finding that newborn and maternal survival primarily drove women’s satisfaction suggests that quantitative assessments conducted shortly following delivery may be overly influenced by these outcomes and not fully capture the complexity of women’s care experience.

2021 ◽  
Author(s):  
Ashley Hagaman ◽  
Humberto Gonzalez Rodriguez ◽  
Clare Barrington ◽  
Kavita Singh ◽  
Abiy Seifu Estifanos ◽  
...  

Abstract Background: Globally, amidst increased utilization of facility-based maternal care services, there is continued need to better understand women’s experience of care in places of birth. Quantitative surveys may not sufficiently characterize satisfaction with maternal healthcare (MHC) in local context, limiting their interpretation and applicability. The purpose of this study is to untangle how contextual and cultural expectations shape women’s care experience and what women mean by satisfaction in two Ethiopian regions. Methods: Health center and hospital childbirth care registries were used to identify and interview 41 women who had delivered a live newborn within a six-month period. We used a semi-structured interview guide informed by the Donabedian framework to elicit women’s experiences with MHC and delivery, any prior delivery experiences, and recommendations to improve MHC. We used an inductive analytical approach to compare and contrast MHC processes, experiences, and satisfaction. Results: Maternal and newborn survival and safety were central to women’s descriptions of their MHC experiences. Women nearly exclusively described healthy and safe deliveries with healthy outcomes as ‘satisfactory’. The texture behind this ‘satisfaction’, however, was shaped by what mothers bring to their delivery experiences, creating expectations from events including past births, experiences with antenatal care, and social and community influences. Secondary to the absence of adverse outcomes, health provider’s interpersonal behaviors (e.g., supportive communication and behavioral demonstrations of commitment to their births) and the facility’s amenities (e.g., bathing, cleaning, water, coffee, etc) enhanced women’s experiences. Finally, at the social and community levels, we found that family support and material resources may significantly buffer against negative experiences and facilitate women’s overall satisfaction, even in the context of poor-quality facilities and limited resources. Conclusion: Our findings highlight the importance of understanding contextual factors including past experiences, expectations, and social support that influence perceived quality of MHC and the agency a woman has to negotiate her care experience. Our finding that newborn and maternal survival primarily drove women’s satisfaction suggests that quantitative assessments conducted shortly following delivery may be overly influenced by these outcomes and not fully capture the complexity of women’s care experience.


2021 ◽  
Author(s):  
Chloe Parton ◽  
Jane M. Ussher ◽  
Janette Perz

Abstract Background Rheumatoid arthritis (RA) can result in difficulties for mothers when undertaking daily care activities and increased psychological distress. However, few studies have examined how women with RA subjectively experience coping and wellbeing as part of their motherhood. Methods Twenty mothers with a diagnosis of RA and a dependent child (18 years or younger) who were living in Australia took part in a semi-structured interview between June and November 2017. Purposive sampling was undertaken to include participants across degree of current RA severity, number and age of children, and having received a diagnosis before or after a first child to take account of variability across these experiences. A qualitative thematic analysis was conducted on the interview transcripts. Results The following themes were identified: ‘Burden and complexity in the mothering role’, ‘Losing control: Women’s experiences of distress’, and ‘Adjusting and letting go: Women’s experiences of wellbeing’. Experiences of distress, including feelings of failure, were associated with accounts of a loss of control over mothering practices among women, regardless of child age. In contrast, accounts of adjusting mothering practices and relinquishing control were associated with reports of enhanced wellbeing. In addition, some mothers reported greater ease due to increased independence of older children. The absence of social support exacerbated burden and distress in the women’s accounts, while the availability of support alleviated burden and was associated with reports of wellbeing. Conclusion Health professionals and services can provide support to mothers with RA by addressing feelings of failure, acknowledging strategies of adjustment and letting go, and encouraging access to social support.


Author(s):  
Rabia Ali ◽  
Ume Habiba ◽  
Hazir Ullah

In Pakistan there are unique socio-cultural factors that contribute to women’s experiences of pregnancy and childbirth. This study explores Pakistani women’s experiences of pregnancy and childbirth an area that remains under researched in the country. Qualitative research was employed for data collection by using an un-structured interview guide. The informants included twelve women who had recently been through the childbirth process for the first and second time. The collected data reveals that women were unaware of the use of multi vitamins during pregnancy. They delayed physical check-ups with a gynaecologist. Women encountered challenges at work during pregnancy and encountered work family conflict after childbirth. Support from intimate relations including husbands and in-laws were reported by the respondents. Attitude of colleagues at work was not always positive during pregnancy. The working women reported being overburdened at work. It is suggested that women friendly policies are required for working women giving birth. Facilities including rest rooms, medical centres need to be provided to the women at work. Women need to be educated about the importance of health care during pregnancy.


2019 ◽  
Vol 5 (2) ◽  
pp. 1
Author(s):  
Arimaya Yates ◽  
Linda Katherine Jones ◽  
Merv Jackson

Objective: Before the beginning of medicalisation in Australia during the 1950s, childbirth was the sole domain of women. Contemporary birthing practices have posed a more medicalised technological environment on women resulting in both good and bad outcomes. In recent surveys, 45.5% of Australian women reported experiencing birth as traumatic; with nearly 20% experiencing postnatal depression. While there have been some studies on women’s trauma experiencing a caesarean section, minimal research has been completed into perceived traumatic experiences related to normal vaginal births.Methods: This study utilized a qualitative methodology to explore psychological and emotional impact of women’s experiences with perceived traumatic normal births. The research used an in-depth semi-structured interview and analysed the data within the phenomenological paradigm. The data analysis revealed nine themes: I was determined to birth naturally; Not telling me what they were doing; I just had to force her to be born; it was really horrific; I know that is just what the system is like. . . they’re hospital midwives. . . they’re medical; I didn’t feel connected to them; She stood up for me; After the birth, just horrible; I deserve a better birth.Results: Although the rates are unclear, these findings highlight that some women suffer trauma from their experience of a normal vaginal birth. The perceived causes include: midwives not always being with women and supporting physiological childbirth; women not being fully informed; power asymmetries and hegemony inside the birthing room; and a fetocentric model of care that left women feeling disrespected, disempowered and objectified.Conclusions: The findings indicate a need for midwives to truly be with women and provide continuity of care, as well as supporting the physiological process of childbirth, medical and midwifery professional education on trauma awareness following birth, a rethinking of antenatal education programs to include coping strategies and greater midwifery support in the hospital post-natal stay.


Genealogy ◽  
2021 ◽  
Vol 5 (2) ◽  
pp. 49
Author(s):  
Bryanna Scott

In Canada, there are three groups of Aboriginal people, also referred to as Indigenous peoples, and these include the First Nations, Inuit, and Métis. Although often thought of collectively, each has its distinct history, culture, and perspectives. The Métis people are mixed-culture people stemming from a long history of Indigenous people and European settlers intermixing and having offspring. Furthermore, the living history representing mixed ancestry and family heritage is often ignored, specifically within higher education. Dominant narratives permeate the curriculum across all levels of education, further marginalizing the stories of Métis people. I explore the experiences of Métis women in higher education within a specific region in Canada. Using semi-structured interview questions and written narratives, I examine the concepts of identity, institutional practices, and reconciliation as described by Métis women. Results assist in providing a voice to the Métis women’s experiences as they challenge and resist colonial narratives of their culture and expand upon a new vision of Métis content inclusion in higher education as reconciliation.


1996 ◽  
Vol 41 (10) ◽  
pp. 1022-1024 ◽  
Author(s):  
Margaret R. Rogers ◽  
Meryl Sirmans

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