Chinkam S, Ibrahim BB, Diaz B, Steer-Massaro C, Kennedy HP, Shorten A. Learning from women: Improving experiences of respectful maternity care during unplanned caesarean birth for women with diverse ethnicity and racial backgrounds.
Women Birth 2023;
36:e125-e133. [PMID:
35610171 DOI:
10.1016/j.wombi.2022.05.004]
[Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 05/01/2022] [Accepted: 05/08/2022] [Indexed: 01/25/2023]
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.
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