Childbirth experiences in low-income communities: A qualitative case study of mothers in rural western Uganda
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Background
This study analyzed the birth experiences of rural Ugandan mothers who delivered by emergency C-section, and who received free care sponsored by a not-for-profit organization. There is little research done on the birth experience in sub-Saharan Africa, particularly on childbirth experience during C-section. The results from this study should provide information to improve the quality of maternal services for low-income families in rural African communities.
Methods
The study methodology included in-depth, semi-structured, open-ended patient interviews with eight post-natal young mothers (ages 18-25) who received emergency C-section care sponsored by the SAFE program in Nyakibale and Rushoroza hospitals, Uganda. The interviews were recorded in two local languages, Runyankole and Rukiga, and later translated and transcribed into English. The sample was of convenience and included women who were para 2 after delivery and reported patient experience as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems patient experience tool. The data analysis was based on a thematic review approach.
Results
Several study participants were delayed in securing appropriate emergency obstetric care due to inexperience with unexpected labor signs, long distance between home and delivery hospital, access to transportation. Most participants expressed a positive delivery experience during labor and postpartum. Although the sponsoring organization covered all surgery and medical bills, other costs, such as transportation and food were not included, creating distress among the participating mothers.
Conclusion
A positive birth experience improves the health of the mother and her child, the mother–child relationship, and overall family well-being. The challenges faced by low-income mothers in rural areas of Uganda, highlight the importance of expanding targeted childbirth preparation and education. The delivery experience can be greatly enhanced with strict quality of care protocols like those implemented by the SAFE program, which include creating a culture of respect for the mother. Direct and indirect costs of healthcare in Uganda are a big challenge for low-income mothers in rural areas who pay out of pocket for these services. Programs like SAFE mitigate economic hardships of poor families and can serve as financing models for government institutions or other NGOs.
