In many African countries, women’s disempowerment and subjugation affect their reproductive health services utilization. This situation becomes even more problematic for women during their vulnerable moments of childbirth. Although copious literature exists on women’s experiences in navigating socio-cultural, religious, economic and structural barriers during childbirth, there is paucity of literature on women’s perceptions of childbirth globally. Extant studies generally focus on health professionals’ and researchers’ perspectives on childbirth. This case study was conducted in two rural communities in Girar Jarso woreda of Ethiopia to explore women’s experiences and perceptions of childbirth. The purpose of this study was to understand the local contexts in which women live and their implications for women’s choice of place of birth and/or birth attendants in Girar Jarso woreda. It is hoped that this study would inform efforts to improve maternity health services delivery and uptake in Ethiopia. This case study was conducted within intersectionality theoretical framework. Data were collected through focus group discussions, in-depth interviews, observation, fieldnotes and cultural interpretations. The data were analyzed and interpreted through social constructionist epistemological lens. This study employed inductive thematic analytical approach. The findings of this study were presented under themes consistent with research questions and were later analyzed and discussed in detail. The findings revealed that institutional birth is gaining popularity in Girar Jarso woreda in the face of socio-cultural, religious, economic, structural and personal barriers. The improvements in institutional birth can be attributed to the Ethiopian government’s persistent efforts to improve maternal, newborn and child health through policies, programs and initiatives. Despite improvements, transportation, health system characteristics, communal decision-making, preference for traditional birth among others, impede efforts to increase institutional birth. This study concluded that women’s experiences and perceptions of childbirth in Girar Jarso woreda are varied. Women’s powerlessness and men’s dominant decision-making position in Ethiopian society affect women’s birth experiences. To improve women’s overall birth experiences, mechanisms need to be established to address patriarchy, women’s rights, transportation challenges, and attitudes of health professionals towards laboring women. The health development program needs reconfiguration to involve men, elderly women and community leaders in reproductive health communication efforts. Efforts should be made to integrate traditional birthing practices into modern obstetric services in the health system. Finally, there is a need for greater collaboration between health extension workers, traditional birth attendants and women development armies in the delivery of community maternity health services.

Obesity is a steadily growing problem, and has both physiological and psychological consequences during pregnancy. Obese women may face discrimination which could shape their perceptions of maternity care. To date, few studies have studied the influence of body weight on patient satisfaction with care. The objectives of this study were: (1) to compare childbirth experiences and satisfaction with intrapartum care of normal weight (BMI between 18.5 and 24.9 kg/m2) and obese (BMI greater than or equal to 30.0 kg/m2) women and (2) to determine factors associated with satisfaction with intrapartum care. Guided by Barker’s (1997) pragmatic model of patient satisfaction, a descriptive comparative and correlational design was used to examine the relationship between childbirth experiences, weight discrimination, and satisfaction with intrapartum care among normal weight and obese women. Postpartum primiparous women (N = 138) in two Winnipeg hospitals completed a questionnaire package and had their chart reviewed (70 normal weight, 68 obese weight). Results: Using independent t-test, no significant differences in satisfaction with intrapartum care or childbirth experiences were found in the two weight groups. In the linear multiple regression model, perceived weight discrimination during labour and delivery was negatively associated (β = -5.78, p = 0.032), while professional support (β = 13.11, p < .001) and perceived control and safety (β = 3.25, p = 0.032) were positively associated with satisfaction with intrapartum care. Understanding factors that influence satisfaction with intrapartum care will assist healthcare providers and administrators to improve satisfaction in all women regardless of their weight. / May 2016

There is low use of health facilities for childbirth in South Sudan despite the majority of households reporting access to a health facility. South Sudan has a high maternal mortality ratio with 789 maternal deaths for every 100,000 live births. The absence of a midwife during labor and delays in reaching health facilities for childbirth remain the leading contributing factors to the high maternal mortality. Little is known, however, about factors influencing use and non-use of health facilities for delivery in the country. This phenomenological study, therefore, seeks to build a body of evidence by describing the experiences of women using health facilities for childbirth. Applying the health belief model, structured interviews were conducted confidentially with 20 women between the ages of 18 and 45 who delivered at the Juba Teaching Hospital. Interviews were voice recorded, transcribed, and analyzed by hand-coding and through NVivo computer software. A review of copied data, comparison with field notes, and member checking were done to ensure data quality. Five broad themes emerged based on the research questions and linked these to the theoretical model. Findings revealed that women received support and assistance during their childbirth experience at the hospital from their husbands, mothers-in-law, health workers, and neighbors. Women reported negative factors such as hunger and positive factors such as care provided by midwives as affecting their childbirth experiences. This research could contribute to improving health outcomes for women and newborns. This study has implications for positive social change by transforming the provision of maternity services in South Sudan.

Using a critical feminist approach, and with attention to participants’ broad life experiences, this qualitative study explores seven women’s challenging, transformative decisions to give birth at home with midwives in Ontario, Canada. To make this choice, the women had to draw on their own strength, take responsibility for their decisions, and resist the dominant view of birth as inherently risky, and of women’s birth experiences as unimportant and incompatible with more narrowly defined good outcomes. As participants became informed decision-makers, resisted medicalized birth, and envisioned more woman-centred possibilities, they were empowered as active agents in their births. They were able to trust that with the care of their midwives, and the support of their partners or close family, they could have satisfying and safe births at home.

Using a critical feminist approach, and with attention to participants’ broad life experiences, this qualitative study explores seven women’s challenging, transformative decisions to give birth at home with midwives in Ontario, Canada. To make this choice, the women had to draw on their own strength, take responsibility for their decisions, and resist the dominant view of birth as inherently risky, and of women’s birth experiences as unimportant and incompatible with more narrowly defined good outcomes. As participants became informed decision-makers, resisted medicalized birth, and envisioned more woman-centred possibilities, they were empowered as active agents in their births. They were able to trust that with the care of their midwives, and the support of their partners or close family, they could have satisfying and safe births at home.