title: Survivors' understanding of vulnerability and resilience to maternal near-miss obstetric events in Uganda.
abstract: OBJECTIVE
  To gain an understanding of how obstetric complications affect the lives and livelihoods of survivors.
  
  
  METHODS
  A phenomenological study was conducted between April and August 2013 at Mulago Hospital, Kampala, Uganda. Data were collected through in-depth interviews among 36 women admitted with obstetric near miss. The interviews investigated perceptions, lived experiences, and meanings attached to such experiences by survivors. More specifically, the questions explored: self-rated health; anticipated social, sexual, and reproductive health challenges; and mitigating factors.
  
  
  RESULTS
  The identified themes were prior expectations, vulnerability, body and social capital, and resilience. Women were found to approach childbirth with predetermined expectations that influenced their pregnancy and childbirth experience. Fatalism, expectations, and social insecurity markedly contributed to vulnerability. Resilience factors included ability to institute adaptations and to harness body and social capital.
  
  
  CONCLUSIONS
  Vulnerabilities and their determinants were found to be inter-related. Individuals' social capital fluctuates over the acute crisis, necessitating multiple adaptations and coping strategies to reduce vulnerability or increase resilience. Although social and body capital may be mobilized to mitigate the effects of the obstetric crisis, they can either worsen vulnerability or increase resilience.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda. Electronic address: dankkaye@yahoo.com.
authors.forename: Dan K
authors.initials: DK
authors.lastname: Kaye
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Othman
authors.initials: O
authors.lastname: Kakaire
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Annettee
authors.initials: A
authors.lastname: Nakimuli
authors.affiliation: Department of Nursing, School of Health Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Scovia N
authors.initials: SN
authors.lastname: Mbalinda
authors.affiliation: Department of Obstetrics and Gynecology, Jinja Regional Hospital, Jinja, Uganda.
authors.forename: Michael O
authors.initials: MO
authors.lastname: Osinde
authors.affiliation: Clinical, Operations and Health Services Research Program, Joint Clinical Research Centre, Kampala, Uganda.
authors.forename: Nelson
authors.initials: N
authors.lastname: Kakande
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007744:Obstetric Labor Complications / Q000523:psychology; D010465:Perception; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D055500:Resilience, Psychological; D012959:Socioeconomic Factors; D017741:Survivors / Q000523:psychology*; D014454:Uganda; D055815:Young Adult
keywords: Body capital; Household finances; Maternal near miss; Quality of life; Resilience; Severe obstetric complications; Social capital; Uganda; Vulnerability