Browsing by Subject "Childbirth"

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    Adolescents' experiences of care during childbirth in health facilities in rural Northern Uganda: a mixed-methods study
    (2025) Udho, Samson; Clow, Sheila
    Background: Despite the importance of care experience during childbirth, there is a dearth of literature on adolescents' experiences of care during childbirth and how their experiences influence their satisfaction with care and future utilization of healthcare facilities. This study examined adolescents' perceptions of PCMC during childbirth in health facilities in rural northern Uganda and how their perceptions influenced their satisfaction with care and future childbearing intentions (intentions to give birth, give birth in the same facility, and recommend the same facility to a sister or friend), and explored the drivers of adolescents' experiences of care during childbirth. Methods: A mixed-methods study was conducted among 570 adolescents aged 14 to 19 years who gave birth in public health facilities in northern Uganda. Adolescents' perceptions of PCMC were measured using the PCMC tool, satisfaction with care was measured using the Six Simple Questions tool, and future childbearing intention was measured using questions from the Community Survey tool. Qualitative data was collected from 14 purposively sampled participants using in-depth interviews. Quantitative data were analysed using descriptive and regression analyses, while qualitative data were analysed thematically and integrated with quantitative data. Results: The PCMC percentage mean score out of 100% was 62% (SD ± 10.12), and percentage mean scores for sub-scales of dignity and respect was 60% (SD ± 12.05), 59% (SD ± 17.12) for communication and autonomy, and 63% (SD ± 9.92) for supportive care. Adolescents' perceptions of moderate/high PCMC during childbirth were positively associated with being married (AOR = 2.61, 95% CI: [1.01, 6.76]), doing casual labour (AOR = 3.18, 95% CI: [1.52, 6.68]), and having an episiotomy (AOR = 1.88, 95% CI: [1.05, 3.36]). Conversely, five to seven antenatal visits (AOR = 0.52, 95% CI: [0.33, 0.83]), birth companionship (AOR = 0.34, 95% CI: [0.19, 0.60]) and having a newborn with complications (AOR = 0.25, 95% CI: [0.09,0.68]) were negatively associated. The mean satisfaction with the care score was 30.12/42 (SD ± 4.10). Adolescents perceived moderate and high levels of PCMC during childbirth were positively associated with satisfaction with care (β = 4.01, 95% CI [3.14, 4.88], p < 0.001and β = 4.38, 95% CI [2.91, 5.86], p < 0.001 respectively). Most adolescents expressed intentions to have another child (82%), return to the same facility for future childbirth (83%), and recommend the same facility to a sister or friend (85%). Adolescents perceived moderate and high levels of PCMC during childbirth were positively associated with intentions to choose the same facility for the next childbirth (AOR=2.84, 95% CI [1.61, 5.00] and AOR=5.60, 95% CI [1.19, 26.43] respectively) and recommend the facility to a sister or friend (AOR=4.31, 95% CI [2.46, 7.54]). Adolescents had mixed experiences during childbirth, ranging from positive experiences of effective communication, dignity and respect, supportive care, and health facility hygiene to negative experiences of disrespect and abuse, and health facility constraints. Negative experiences were associated with lack of birthing necessities, younger age, and perceived low social status while positive experiences were driven by passive compliance, calm demeanor, relational skills, possession of birthing necessities, cleanliness, and smartness. Conclusion: Adolescents' varied experiences of care during childbirth, influenced by various individual-level factors, resulted in perceptions of moderate PCMC during childbirth. PCMC has the potential to enhance childbirth experience for adolescent mothers, as well as influence their satisfaction with care and future childbearing intentions.
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    Birth beyond borders: childbirth experiences of migrant women in Cape Town, South Africa
    (2025) Semenya, Mmapitsi; Knight, Lucia; Jessica, Dutton
    Background Childbirth is significant for women and how it unfolds can influence the outcome of labour and have lasting impacts on them. It is important for women to receive good quality care during this time of intense vulnerability. However, evidence suggests that women are at risk of disrespect and abuse during this phase. South Africa is a top destination for migrants from Africa and migrant women may be more likely to experience discrimination during childbirth. This study therefore aims to explore the childbirth experiences of migrant women and will contribute to our understanding of how to address their health care needs during childbirth. Methods The qualitative study was conducted in Cape Town, South Africa. Using an exploratory approach, participants were purposively sampled in collaboration with the Scalabrini Centre of Cape Town. The study included eight women from various African countries. Participants were interviewed using a semi-structured interview guide and thematic analysis was applied to the data. The reproductive justice framework was used to organise interview findings. Results The study revealed that migrant women had positive experiences during childbirth but also reported negative events. Women were satisfied with health care services in South Africa, compared to their countries of origin. Particularly that they didn't have to pay for services, health care workers (HCW) provided them with information about health care procedures and HCW were available to assist them when they needed help. Some women however, reported being neglected, treated unfairly and discriminated against. Some, especially negative experience, might have not been exclusive to migrant women but might have been worsened because of their migration status. Conclusion Women reported having positive childbirth experiences. However, the study also revealed that even though South African legislations protect migrant's right to health, migrant women still experience negative experiences during childbirth. Some negative experiences may have been heightened because of discrimination against migrants in public health care facilities. Therefore, it is essential that interventions are developed, such as the use of interpreters, to support migrant women during childbirth. Furthermore, healthcare workers must adhere to the already existing legislation, and migrant women must be provided with information on accessible channels to report any ill-treatment during childbirth.
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    Medicalised maternity : an investigation into women's experiences of medicalised childbirth
    (1998) Humphreys, Katherine Louise; Jubber, Ken
    This dissertation reports on a qualitative study of the childbearing experiences of 20 women having their first child. The study attempts to examine the dominant discourses surrounding pregnancy, childbirth and motherhood, with specific reference to the medical discourse, and to describe the way in which these impact on the women's experiences. The non-probability, convenience sample used in the study comprised women attending an antenatal class held at a Cape Town private hospital. The sample was relatively socially and medically homogeneous. The size and nature of the sample makes broad generalisations tentative. Individual interviews based on in-depth and open-ended questions were conducted. These were aimed at gathering qualitative data on the women's perceptions of their experiences. The women were interviewed during the last trimester of pregnancy about their experiences of pregnancy and their anticipation of childbirth. A further interview conducted a few weeks after birth focused on their experience of childbirth within the hospital setting and their impressions of early motherhood. It was found that the women's accounts of their experiences of pregnancy, childbirth and early motherhood were shaped to a large extent by the discourses within which the process of childbearing has been constructed. These include the medical, 'natural' birth and feminine discourses. The dominance of the medical discourse of birth was evident in the fact that the medical view was thoroughly incorporated into the women's perceptions of their childbearing experiences. This view of birth, along with the dominance of scientific medical knowledge, was found to limit the perception of acceptable birthing practice. The medical discourse intersected with both the 'natural' birth discourse which, as a social construction, was shown to uphold essentialist and prescriptive notions of motherhood, and the feminine discourse. This discourse, along with its assumptions regarding the mothering role, was fom1d to impact on the women's experiences through the creation of unrealistic expectations and ideals, which contributed to the shock and stress of first-time motherhood.
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    Socioeconomic inequalities in access and use of skilled birth attendants during childbirth in Ghana: a decomposition analysis
    (2021-12-31) Kpodotsi, Aseye; Baku, Elizabeth A.; Adams, Jo H.; Alaba, Olufunke
    Background Equitable access to skilled birth attendance during delivery is vital for reducing global maternal deaths to 70 deaths per 100, 000 to achieve the Sustainable Development Goals (SDGs) by 2030. Although several initiatives have been implemented to reduce maternal mortality in Ghana, inequalities in access to skilled birth attendance during delivery still exist among women of different socioeconomic groups. This study assesses the socioeconomic inequalities in access and use of skilled birth attendants during delivery in Ghana. Methods Research was conducted through literature reviews and document reviews, and a secondary data analysis of the 2014 Ghana Demographic and Health Survey (GDHS), a nationally representative survey. A total of 1305 women aged 15–49 years, who had a live birth the year before to the survey in the presence of a skilled birth attendant were analysed using concentration indices and curves. The indices were further decomposed to identify the major socioeconomic factors contributing most to the inequalities. Results The results found that access to skilled birth attendants was more among women from rich households showing a pro-rich utilization. The decomposition analysis revealed that household wealth index, educational level of both mother and husband/partner, area of residence and mother’s health insurance coverage were the major contributing factors to socioeconomic inequalities in accessing skilled birth attendants during child delivery among Ghanaian women. Conclusion This study confirms that a mother’s socioeconomic status is vital to reducing maternal deaths. Therefore, it is worthy to focus attention on policy interventions to reduce the observed inequalities as revealed in the study.