Women’s lived experiences and support needs following emergency caesarean section in Kawempe national referral hospital. A qualitative study.

Abstract

Background-Globally, Caesarean Section (CS) delivery is estimated at 21.1%. It has tripled from 7% in 1990 and projected to reach 28.5% by 2030. In Kawempe National Referral Hospital (KNRH), 43% of women delivered by CS in 2022, and 95% of whom were a result of emergency caesarean section (EmCS). However, the lived experiences and support needs of women following CS had not been explored, despite knowledge on challenges associated with CS compared to vaginal birth. This study explored the lived experiences and support needs of women following EmCS in KNRH. Methods-A phenomenological study in the post-natal clinic of KNRH was conducted among women reviewed on their 6th week following EmCS, and health workers as Key informants (KIs) in KNRH. In-depth audio-recorded interviews for women and KI interviews were conducted. The audio records were transcribed verbatim and analysed manually using both deductive and inductive thematic techniques. Results-Twenty (20) in-depth interviews and six (6) KI interviews were conducted between June and July 2023. The Mean age of the women was 27.95 years. Most women highlighted negative experiences at individual, relationship and health care levels, including fear of death during the surgery, poor pain control, and unsatisfactory hospital care such as delays in intervention, poor communication, feelings of discrimination and neglect and informal hospital charges. Conversely, successful surgery that saved their lives and that of their babies, trust and confidence of being managed by qualified staff in a national referral hospital were highlighted. The need for adequate pre-operative care, financial resources, adequate pain control and enough time required for interaction with health workers to improve on the care during EmCS were expressed by both the women and KIs. Conclusion and Recommendation-Following EmCS, women have both positive and negative experiences. Positive experiences included successful surgery with both woman and baby alive, companionship and being managed in national referral hospital. However, negative experiences included fear of death for mother and baby, poor pain control, poor communication, informal hospital charges and repeat surgeries were expressed. Financial support, companionship and information on indications for surgery and other interventions were the needs expressed by the women. This study underpins the need for pain control, emphasis on the significance of EmCS, shared decision making, financial support and choice of companionship to promote respectful maternity care in KNRH.