Narratives of distress about birth in South African public maternity settings: a qualitative study.
OBJECTIVE
to explore the factors associated with negative birth experiences in South African public maternity settings from the perspective of women's birth narratives.


METHODS
an explorative, qualitative research study using a narrative methodological framework and unstructured interviewing.


METHODS
the city of Cape Town in South Africa.


METHODS
33 low-income women aged 18-42 years who had recently given birth to an infant in the public maternity sector.


RESULTS
more than half of the women (n=18) narrated 'narratives of distress' in relation to their birth experiences. One third narrated 'good' birth experiences and four women told minimalistic or neutral birth narratives. This paper reports only on factors associated with women's distress narratives. Narratives of distress were associated with poor quality of intrapartum care and characterised by the following four themes, namely (1) negative interpersonal relations with caregivers, (2) lack of information, (3) neglect and abandonment and (4) the absence of a labour companion.


CONCLUSIONS
poor relationships with caregivers emerged as central to women's distress narratives. Interventions aimed at improving interpersonal communication, connection and rapport between caregivers and labouring women are central to improving quality of care in resource-constrained settings.
Women's Health Research Unit, School of Public Health and Family Medicine, Falmouth Building, Medical Campus, University of Cape Town, Observatory 7925, South Africa. Electronic address: rachellechadwick@yahoo.co.uk.
Rachelle J
RJ
Chadwick
Women's Health Research Unit, School of Public Health and Family Medicine, Falmouth Building, Medical Campus, University of Cape Town, Observatory 7925, South Africa.
Diane
D
Cooper
Women's Health Research Unit, School of Public Health and Family Medicine, Falmouth Building, Medical Campus, University of Cape Town, Observatory 7925, South Africa.
Jane
J
Harries
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008016:Life Change Events; D009775:Obstetrics and Gynecology Department, Hospital; D036801:Parturition / Q000523:psychology*; D017060:Patient Satisfaction; D011247:Pregnancy; D036301:Qualitative Research; D013019:South Africa; D011795:Surveys and Questionnaires
Birth narratives; Birth trauma; Childbirth abuse; Quality of care