Advertisement

Maternity health care: The experiences of Sub-Saharan African women in Sub-Saharan Africa and Australia

Published:December 09, 2016DOI:https://doi.org/10.1016/j.wombi.2016.11.011

      Abstract

      Background

      Increasing global migration is resulting in a culturally diverse population in the receiving countries. In Australia, it is estimated that at least four thousand Sub-Saharan African women give birth each year. To respond appropriately to the needs of these women, it is important to understand their experiences of maternity care.

      Objective

      The study aimed to examine the maternity experiences of Sub-Saharan African women who had given birth in both Sub-Saharan Africa and in Australia.

      Design

      Using a qualitative approach, 14 semi-structured interviews with Sub-Saharan African women now living in Australia were conducted. Data was analysed using Braun and Clark’s approach to thematic analysis.

      Findings

      Four themes were identified; access to services including health education; birth environment and support; pain management; and perceptions of care. The participants experienced issues with access to maternity care whether they were located in Sub-Saharan Africa or Australia. The study draws on an existing conceptual framework on access to care to discuss the findings on how these women experienced maternity care.

      Conclusion

      The study provides an understanding of Sub-Saharan African women’s experiences of maternity care across countries. The findings indicate that these women have maternity health needs shaped by their sociocultural norms and beliefs related to pregnancy and childbirth. It is therefore arguable that enhancing maternity care can be achieved by improving women’s health literacy through health education, having an affordable health care system, providing respectful and high quality midwifery care, using effective communication, and showing cultural sensitivity including family support for labouring women.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Women and Birth
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Balaam M.C.
        • Akerjordet K.
        • Lyberg A.
        • et al.
        A qualitative review of migrant women’s perceptions of their needs and experiences related to pregnancy and childbirth.
        J Adv Nurs. 2013; 69: 1919-1930
        • Smith M.M.
        Refugees in Australia: changing faces, changing needs.
        Med J Aust. 2006; 185: 587-588
        • Correa-Velez I.
        • Ryan J.
        Developing a best practice model of refugee maternity care.
        Women Birth. 2012; 25: 13-22
      1. Australian Bureau of Statistics. Migration. 2009–2010. http://www.abs.gov.au/ausstats/[email protected]/0/52F24D6A97BC0A67CA2578B0001197B8?opendocument [Accessed 8 October 2016].

        • World Health Organization
        Trends in maternal mortality: 1990 to 2013: estimates by WHO, UNICEF, UNFPA.
        The World Bank and the United Nations Population Division: executive summary. World Health Organization, Geneva2014
        • Australian Institute of Health and Welfare
        Maternal deaths in Australia 2006–2010.
        Australian Institute of Health and Welfare, Canberra2014
        • Kinney M.V.
        • Kerber K.J.
        • Black R.E.
        • et al.
        Sub-Saharan Africa’s mothers, newborns, and children: where and why do they die?.
        Public Lib Sci Med. 2010; 7: e1000294
        • World Health Organization
        Standards for maternal and neonatal care.
        World Health Organization, Geneva2007
        • World Health Organization
        WHO recommendations on postnatal care of the mother and newborn.
        World Health Organization, 2014
        • Scheil W.
        • Jolly K.
        • Scott J.
        • Catcheside B.
        • Sage L.
        • Kennare R.
        Pregnancy outcome in South Australia 2013. 2015. Pregnancy Outcome Unit: Government of South Australia, Adelaide2015
        • Straus L.
        • McEwen A.
        • Hussein F.M.
        Somali women’s experience of childbirth in the UK: perspectives from Somali health workers.
        Midwifery. 2009; 25: 181-186
        • Higginbottom G.M.
        • Safipour J.
        • Mumtaz Z.
        • Chiu Y.
        • Paton P.
        • Pillay J.
        I have to do what I believe: Sudanese women’s beliefs and resistance to hegemonic practices at home and during experiences of maternity care in Canada.
        Bio Med Cent Pregnancy Childbirth. 2013; 13: 51
        • Brighton A.
        • D’Arcy R.
        • Kirtley S.
        • Kennedy S.
        Perceptions of prenatal and obstetric care in Sub-Saharan Africa.
        Int J Gynecol Obstetrics. 2013; 120: 224-227
        • Murray L.
        • Windsor C.
        • Parker E.
        • Tewfik O.
        The experiences of African women giving birth in Brisbane, Australia.
        Health Care Women Int. 2010; 31: 458-472
        • Carolan M.
        • Cassar L.
        Antenatal care perceptions of pregnant African women attending maternity services in Melbourne, Australia.
        Midwifery. 2010; 26: 189-201
        • Mrisho M.
        • Obrist B.
        • Schellenberg J.A.
        • et al.
        The use of antenatal and postnatal care: Perspectives and experiences of women and health care providers in rural southern Tanzania.
        BMC Pregnancy Childbirth. 2009; 9
        • Renzaho A.M.
        • Oldroyd J.C.
        Closing the gap in maternal and child health: a qualitative study examining health needs of migrant mothers in Dandenong, Victoria, Australia.
        Matern Child Health J. 2014; 18: 1391-1402
        • Berggren V.
        • Bergström S.
        • Edberg A.-K.
        Being different and vulnerable: experiences of immigrant African women who have been circumcised and sought maternity care in Sweden.
        J Transcult Nurs. 2006; 17: 50-57
        • Wilunda C.
        • Quaglio G.
        • Putoto G.
        • et al.
        A qualitative study on barriers to utilisation of institutional delivery services in Moroto and Napak districts, Uganda: implications for programming.
        BMC Pregnancy Childbirth. 2014; 14: 259
        • Hennegan J.
        • Redshaw M.
        • Miller Y.
        Born in another country: women’s experience of labour and birth in Queensland, Australia.
        Women Birth. 2014; 27: 91-97
        • Benza S.
        • Liamputtong P.
        Pregnancy, childbirth and motherhood: a meta-synthesis of the lived experiences of immigrant women.
        Midwifery. 2014; 30: 575-584
        • Gibson-Helm M.E.
        • Teede H.J.
        • Block A.A.
        • et al.
        Maternal health and pregnancy outcomes among women of refugee background from African countries: a retrospective, observational study.
        Bio Med Cent Pregnancy Childbirth. 2014; 14: 392
        • Stapleton H.
        • Murphy R.
        • Correa-Velez I.
        • Steel M.
        • Kildea S.
        Women from refugee backgrounds and their experiences of attending a specialist antenatal clinic. Narratives from an Australian setting.
        Women Birth. 2013; 26: 260-266
        • Gibson-Helm M.
        • Teede H.
        • Block A.
        • et al.
        Maternal health and pregnancy outcomes among women of refugee background from African countries: a retrospective, observational study in Australia.
        Bio Med Cent Pregnancy Childbirth. 2014; 14
        • McMahon S.A.
        • George A.S.
        • Chebet J.J.
        • Mosha I.H.
        • Mpembeni R.N.
        • Winch P.J.
        Experiences of and responses to disrespectful maternity care and abuse during childbirth; a qualitative study with women and men in Morogoro Region, Tanzania.
        BMC Pregnancy Childbirth. 2014; 14: 268
        • Chadwick R.J.
        • Cooper D.
        • Harries J.
        Narratives of distress about birth in South African public maternity settings: a qualitative study.
        Midwifery. 2014; 30: 862-868
        • Hodnett E.D.
        • Gates S.
        • Hofmeyr G.J.
        • Sakala C.
        • Weston J.
        Continuous support for women during childbirth.
        Cochrane Database Syst Rev. 2011; 2
        • Ehiri J.
        Maternal and child health: global challenges, programs and policies.
        Springer, USA2009
        • Liamputtong P.
        Research methods in health: foundations for evidenced based practice.
        2nd ed. Australia Oxford University Press, 2013
        • Parahoo K.
        Nursing research: principles, process and issues.
        3rd ed. Palgrave Macmillan, Basingstoke2014
        • Schneider Z.
        • Whitehead D.
        • LoBiondo-Wood G.
        • Haber J.
        Nursing and midwifery research: methods and appraisal for evidence-based practice.
        4th ed. Elsevier Australia, Sydney2013
        • Polit D.F.
        • Beck C.T.
        Nursing research generating and assessing evidence for nursing practice.
        9th ed. Lippincott Williams & Wilkins, Philadelphia2012
        • Creswell J.W.
        Research design qualitative, quantitative, and mixed methods approaches.
        4th ed. SAGE Publications, London2013
        • Gill P.
        • Stewart K.
        • Treasure E.
        • Chadwick B.
        Methods of data collection in qualitative research: interviews and focus groups.
        Br Dent J. 2008; 204: 291-295
        • Braun V.
        • Clarke V.
        Using thematic analysis in psychology.
        Qual Res Psychol. 2006; 3: 77-101
        • Saldana J.
        The coding manual for qualitative researchers.
        SAGE Publications, 2009
        • Levesque J.-F.
        • Harris M.F.
        • Russell G.
        Patient-centred access to health care: conceptualising access at the interface of health systems and populations.
        Int J Equity Health. 2013; 12: 18
        • World Health Organization
        Provision of effective antenatal care.
        Standards for maternal and neonatal care. World Health Organization, 2006
        • Calvello E.J.
        • Skog A.P.
        • Tenner A.G.
        • Wallis L.A.
        Applying the lessons of maternal mortality reduction to global emergency health.
        Bull World Health Organ. 2015; 93: 417-423
        • Murawski L.
        • Church R.L.
        Improving accessibility to rural health services: the maximal covering network improvement problem.
        Socio-Econ Plann Sci. 2009; 43: 102-110
        • World Health Organization
        • UNICEF
        Trends in maternal mortality: 1990–2015: estimates from WHO, UNICEF, UNFPA.
        World Bank Group and the United Nations Population Division, 2015
        • Finlayson K.
        • Downe S.
        Why do women not use antenatal services in low-and middle-income countries? A meta-synthesis of qualitative studies.
        Public Lib Sci Med. 2013; 10: e1001373
      2. World Health Organization. Health Workforce. Density of nursing and midwifery personnel. 2015. http://gamapserver.who.int/gho/interactive_charts/health_workforce/NursingMidwiferyDensity/atlas.html [Accessed 5 July 2016].

        • King R.
        • Jackson R.
        • Dietsch E.
        • Hailemariam A.
        Utilisation of maternal health services in Ethiopia: a key informant research project.
        Dev Pract. 2016; 26: 158-169
        • King R.
        • Jackson R.
        • Dietsch E.
        • Hailemariam A.
        Barriers and facilitators to accessing skilled birth attendants in Afar region, Ethiopia.
        Midwifery. 2015; 31: 540-546
        • Bohren M.A.
        • Vogel J.P.
        • Hunter E.C.
        • et al.
        The mistreatment of women during childbirth in health facilities globally: a mixed-methods systematic review.
        Public Lib Sci Med. 2015; 12: e1001847
        • Murray S.B.
        • Skull S.A.
        Hurdles to health: immigrant and refugee health care in Australia.
        Aust Health Rev. 2005; 29: 25-29
        • WHO
        • UNFPA
        • UNICEF
        • AMDD
        Monitoring emergency obstetric care: a handbook.
        WHO, Geneva2009: 152
        • World Health Organisation
        World health statistics 2016. Monitoring health for the sustainable development goals.
        World Health Organisation, Geneva2016
      3. World Health Organisation. Health Workforce. Density of nursing and midwifery personnel; 2015. http://gamapserver.who.int/gho/interactive_charts/health_workforce/NursingMidwiferyDensity/atlas.html [Accessed 5 July 2016].

        • Jones B.
        • Michael R.
        • Butt J.
        • Hauck Y.
        Tanzanian midwives’ perception of their professional role and implications for continuing professional development education.
        Nurse Educ Pract. 2015; 17: 116-122https://doi.org/10.1016/j.nepr.2015.12.001