Abstract
Problem
Women from diverse ethnicity and racial backgrounds have few opportunities to share
birth experiences to inform improvements in care.
Background
Respectful maternity care is recognised as a global women’s health priority. Integrating
that framework into diverse care systems and models may help bridge care gaps for
women who had unexpected birth experiences, including unplanned caesarean birth.
Aim
To describe the experiences of women who had unplanned caesarean births and use knowledge
gained to inform best practice recommendations that embody respectful maternity care.
Methods
Qualitative data were analysed from focus groups involving a convenience sample of
11 English speaking women, from diverse ethnic and racial backgrounds, with prior
unplanned caesarean experience. Respectful maternity care was used as the lens for
interpreting women’s narratives using Thorne’s interpretive description. The study
site was an outpatient prenatal clinic within an urban academic, tertiary-care medical
centre in the United States.
Findings
Two predominant, contrasting themes emerged: “not feeling well cared for” and “feeling
well supported”. Positive experiences included sources of support and strength from
the midwifery practice, group prenatal care, and a doula program. Eight domains of
respectful maternity care were applied to findings, highlighting current positive
institutional practices and proposing areas for future quality improvement.
Conclusion
Key practices promoting respectful maternity care include adequate communication and
information sharing between pregnancy care providers and women, and a more robust
informed consent process. Further emphasis on respectful maternity care is needed
to support women to make shared decisions that best fit their circumstances and preferences.
Keywords
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Article info
Publication history
Published online: May 21, 2022
Accepted:
May 8,
2022
Received in revised form:
May 1,
2022
Received:
August 19,
2021
Footnotes
☆Research Description : This original article outlines the results of a qualitative pilot study using focus groups to describe women’s experiences of prior caesarean birth in a large, inner-city public hospital and academic medical centre. Nested within a larger study, this work focuses on their stories of unplanned caesarean in order to highlight strategies needed to better support women who have experienced previous caesarean as they make decisions about future childbirth. Respectful maternity care was used as the framework underpinning the analysis.
Identification
Copyright
© 2022 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
