Table 3.
Summary of women’s perceptions and experiences of childbirth
| Domains | Perceptions of quality | Actual experiences |
|---|---|---|
| Place of childbirth | In hospital. | Majority delivered in township hospitals because: |
| County or higher level hospital because: | • Close to home | |
| • Comfortable, clean and quiet environment | • Doctors are good at NVDs | |
| • Good equipment | • Knew doctors because of previous delivery or antenatal care | |
| • Skilled providers who can manage emergencies | Environment: | |
| Environment: | • Township hospitals: rooms, beds and linen were dirty | |
| • Quiet and clean | • County hospitals: Labour and delivery rooms and wards were clean | |
| • Both: noise from streets and corridors; shared room and toilets | ||
| Type of childbirth | NVD: | NVD: |
| • Quicker recovery | • Stay in hospital is shorter than for CS | |
| • Less pain following NVD | • Fewer complications and quicker recovery | |
| • Improves immunity and intelligence of baby | • First baby was NVD | |
| • Less pain with NVD | ||
| Experience of childbirth | • Pain relief which is safe for mother and baby | • Almost all women having NVD did not receive pain relief |
| • Ill prepared for management of pain | ||
| • Received oxytocin infusions to speed up labour and relieve pain | ||
| Skills of birth attendants | • Cause little pain; able to comfort and relieve pain | Majority viewed skills as being good: |
| • Good at watching progress | • Careful, gentle and quick at doing examinations, deliveries and suturing | |
| • Disinfection of equipment and materials | ||
| • Care for mother and baby after delivery | • Putting up IV fluids | |
| • Older, experienced and confident | ||
| Communication between women and birth attendants | • Treat with respect: | • Township hospitals: most received support from doctors |
| ◦ Showing concern | • County hospitals: most received little/no support from staff | |
| ◦ Being kind and friendly | • Both: Doctors did not explain what care they were providing; gave no choice about care; and did not ask consent for investigations or interventions | |
| ◦ Giving information about care | ||
| ◦ Seeking women’s views and consent | ||
| Role of family | Husband and other relatives present for childbirth to provide support and encouragement and deal with problems | Township hospitals: all women had relatives present for NVD |
| County hospitals: only half of women had relatives present |