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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2020

01-12-2020 | Research article

Jordanian women’s experiences and constructions of labour and birth in different settings, over time and across generations: a qualitative study

Authors: Suha Abed Almajeed Abdallah Hussein, Hannah G. Dahlen, Olayide Ogunsiji, Virginia Schmied

Published in: BMC Pregnancy and Childbirth | Issue 1/2020

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Abstract

Background

Overwhelmingly, women in Middle Eastern countries experience birth as dehumanising and disrespectful. Women’s stories can be a very powerful way of informing health services about the impact of the care they receive and can promote practice change. The aim of this study is to examine Jordanian women’s experiences and constructions of labour and birth in different settings (home, public and private hospitals in Jordan, and Australian public hospitals), over time and across generations.

Method

A qualitative interpretive design was used. Data were collected by face-to-face semi-structured interviews with 27 Jordanian women. Of these women, 20 were living in Jordan (12 had given birth in the last five years and eight had birthed over 15 years ago) while seven were living in Australia (with birthing experience in both Jordan and Australia). Interview data were transcribed verbatim and analysed thematically.

Results

Women’s birth experiences differed across settings and generations and were represented in the four themes: ‘Birth at home: a place of comfort and control’; ‘Public Hospital: you should not have to suffer’; ‘Private Hospital: buying control’ and ‘Australian maternity care: a mixed experience’. In each theme, the concepts: Pain, Privacy, the Personal and to a lesser extent, Purity (cleanliness), were present but experienced in different ways depending on the setting (home, public or private hospital) and the country.

Conclusions

The findings demonstrate how meanings attributed to labour and birth, particularly the experience of pain, are produced in different settings, providing insights into the institutional management and social context of birth in Jordan and other Middle Eastern countries. In the public hospital environment in Jordan, women had no support and were treated disrespectfully. This was in stark contrast to women birthing at home only one generation before. Change is urgently needed to offer humanised birth in the Jordanian maternity system,
Literature
1.
Hussein SAAA, Dahlen HG, Duff M, Schmied V. The barriers and facilitators to evidence-based episiotomy practice in Jordan. Women Birth. 2016;29(4):321–9.PubMedCrossRef
2.
Hatamleh R, Sinclair M, Kernohan G, Bunting B. Birth memories of Jordanian women: findings from qualitative data. J Res Nurs. 2013;18(3):235–44.CrossRef
3.
Mohammad K, Alafi K, Mohammad A, Gamble J, Creedy D. Jordanian women's dissatisfaction with childbirth care. Int Nurs Rev. 2014;61(2):278–84.PubMedCrossRef
4.
Oweis A. Jordanian mother's report of their childbirth experience: findings from a questionnaire survey. Int J Nurs Pract. 2009;15(6):525–33.PubMedCrossRef
5.
Jahlan I, Plummer V, McIntyre M. What women have to say about giving birth in Saudi Arabia. Middle East J Nurs. 2016;10(1):10–8.CrossRef
6.
Hussein SA, Dahlen HG, Ogunsiji O, Schmied V. Women’s experiences of childbirth in middle eastern countries: a narrative review. Midwifery. 2018;59:100–11.PubMedCrossRef
7.
El-Nemer A, Downe S, Small N. ‘She would help me from the heart’: an ethnography of Egyptian women in labour. Soc Sci Med. 2006;62(1):81–92.PubMedCrossRef
8.
Bohren MA, Vogel JP, Hunter EC, Lutsiv O, Makh SK, Souza JP, et al. The mistreatment of women during childbirth in health facilities globally: a mixed-methods systematic review. PLoS Med. 2015;12(6):e1001847.PubMedPubMedCentralCrossRef
9.
Hulton LA, Matthews Z, Stones RW. Applying a framework for assessing the quality of maternal health services in urban India. Soc Sci Med. 2007;64(10):2083–95.PubMedCrossRef
10.
Miller S, Abalos E, Chamillard M, Ciapponi A, Colaci D, Comandé D, et al. Beyond too little, too late and too much, too soon: a pathway towards evidence-based, respectful maternity care worldwide. Lancet. 2016;388(10056):2176–92.PubMedCrossRef
11.
Elmir R, Schmied V, Wilkes L, Jackson D. Women’s perceptions and experiences of a traumatic birth: a meta-ethnography. J Adv Nurs. 2010;66(10):2142–53.PubMedCrossRef
12.
Keedle H, Schmied V, Burns E, Dahlen HG. Women’s reasons for, and experiences of, choosing a homebirth following a caesarean section. BMC Pregnancy Child. 2015;15(1):1.CrossRef
13.
Rigg EC, Schmied V, Peters K, Dahlen HG. Why do women choose an unregulated birth worker to birth at home in Australia: a qualitative study. BMC Pregnancy Child. 2017;17(1):1–14 Pubmed Central PMCID: PMC5371179.CrossRef
14.
Dahlen HG, Jackson M, Stevens J. Homebirth, freebirth and doulas: casualty and consequences of a broken maternity system. Women Birth. 2011;24(1):47–50.PubMedCrossRef
15.
Fahy KM, Parratt JA. Birth territory: a theory for midwifery practice. Women Birth. 2006;19(2):45–50.PubMedCrossRef
16.
Walsh D. An ethnographic study of women's experience of partnership caseload midwifery practice: the professional as a friend. Midwifery. 1999;15(3):165–76.PubMedCrossRef
17.
Bernhard C, Zielinski R, Ackerson K, English J. Home birth after hospital birth: women's choices and reflections. J Midwifery Women’s Health. 2014;59(2):160–6.CrossRef
18.
Rigg E, Schmied V, Peters K, Dahlen H. Not addressing the root cause: an analysis of submissions made to the south Australian government on a proposal to protect midwifery practice. Women and Birth. 2015;28(2):121–8.PubMedCrossRef
19.
Lupton D. Medicine as culture: illness, disease and the body. 3rd ed. CA: SAGE Publications Ltd; 2012.
20.
Luce A, Cash M, Hundley V, Cheyne H, Van Teijlingen E, Angell C. “Is it realistic?” the portrayal of pregnancy and childbirth in the media. BMC Pregnancy Child. 2016;16(1):40.CrossRef
21.
Prosen M, Krajnc MT. Perspectives and experiences of healthcare professionals regarding the medicalisation of pregnancy and childbirth. Women Birth. 2019;32(2):e173–e181.
22.
Pazandeh F, Potrata B, Huss R, Hirst J, House A. Women’s experiences of routine care during labour and childbirth and the influence of medicalisation: a qualitative study from Iran. Midwifery. 2017;53:63–70.PubMedCrossRef
23.
Safadi R. Jordanian women: perceptions and practices of first-time pregnancy. Int J Nurs Pract. 2005;11(6):269–76.PubMedCrossRef
24.
Shaban IA. Midwifery: contemporary issues in Jordan Doctoral dissertation. Sydney: University of Technology; 2006.
25.
Sultan F. Nursing in Jordan: start, development and aspirations. Sultan Graphics Centre for design and printing 1998.
26.
World Health Organization. World health statistics 2010. Geneva: World Health Organization; 2010.
27.
World Health Organization. The prevention and elimination of disrespect and abuse during facility-based childbirth: WHO statement. Geneva: World Health Organization; 2014.
28.
Hussein SAAA, Dahlen HG, Ogunsiji O, Schmied V. Uncovered and disrespected. A qualitative study of Jordanian women’s experience of privacy in birth. Women and Birth. 2019.
29.
Elliott R, Timulak L. Descriptive and interpretive approaches to qualitative research. Handbook Res Methods Clin Health Psychol. 2005;1(7):147–59.
30.
Parratt JA, Fahy KM. Including the nonrational is sensible midwifery. Women Birth. 2008;21(1):37–42.PubMedCrossRef
31.
Thorne S, Kirkham SR, O'Flynn-Magee K. The analytic challenge in interpretive description. Int J Qual Methods. 2004;3(1):1–11.CrossRef
32.
Thorne S, Kirkham SR, MacDonald-Emes J. Interpretive description: a noncategorical qualitative alternative for developing nursing knowledge. Res Nurs Health. 1997;20(2):169–77.PubMedCrossRef
33.
Hunt MR. Strengths and challenges in the use of interpretive description: reflections arising from a study of the moral experience of health professionals in humanitarian work. Qual Health Res. 2009;19(9):1284–92.PubMedCrossRef
34.
Ackerly B, True J. Doing feminist research in political and social science: Palgrave Macmillan; 2010.
35.
Pitre NY, Kushner KE, Raine KD, Hegadoren KM. Critical feminist narrative inquiry: advancing knowledge through double-hermeneutic narrative analysis. Adv Nurs Sci. 2013;36(2):118–32.CrossRef
36.
Doucet A, Mauthner N. Qualitative interviewing and feminist research. SAGE Handbook Soc Res Methods. 2008:328–43.
37.
Department of Statistics. Population and family health survey. 2019.
38.
Department of Statistics. Population and family health survey. Jordan 2015.
39.
Nazer LH, Tuffaha H. Health care and pharmacy practice in Jordan. Can J Hospital Pharmacy. 2017;70(2):150.CrossRef
40.
Basu S, Andrews J, Kishore S, Panjabi R, Stuckler D. Comparative performance of private and public healthcare systems in low-and middle-income countries: a systematic review. PLoS Med. 2012;9(6):e1001244.PubMedPubMedCentralCrossRef
41.
Sengupta A, Nundy S. The private health sector in India. British Medical Journal Publishing Group; 2005.
42.
Australian Government Department of Immigration and Border Protection. 2014.
43.
Braun V, Clarke V, Terry G. Thematic analysis. Qual Res Clin Health Psychol. 2014;24:95–114.
44.
Leap N, Sandall J, Buckland S, Huber U. Journey to confidence: women's experiences of pain in labour and relational continuity of care. J Midwifery Women’s Health. 2010;55(3):234–42.CrossRef
45.
Walsh D, Newburn M. Towards a social model of childbirth: part one. MA Healthcare London; 2002.
46.
Kabakian-Khasholian T, Campbell O, Shediac-Rizkallah M, Ghorayeb F. Women’s experiences of maternity care: satisfaction or passivity? Soc Sci Med. 2000;51(1):103–13.PubMedCrossRef
47.
Abushaikha L. Midwifery education in Jordan: history, challenges and proposed solutions. J Int Women's Stud. 2006;8:185.
48.
Khalaf I, Callister LC. Cultural meanings of childbirth: Muslim women living in Jordan. J Holist Nurs. 1997;15(4):373–88.PubMedCrossRef
49.
Leap N, Hunter B. Supporting women for labour and birth: a thoughtful guide: Routledge; 2016.
50.
Stenglin M, Foureur M. Designing out the fear Cascade to increase the likelihood of normal birth. Midwifery. 2013;29(8):819–25.PubMedCrossRef
51.
Sandall J, Soltani H, Gates S, Shennan A, Devane D. Midwife-led continuity models versus other models of care for childbearing women. Cochrane Database Syst Rev. 2015;9.
52.
Wharton E. Twilight Sleep. New York: SCRIBNER PAPERBACK FICTION. Simon and Schuster Inc.; 2012. 236 p.
53.
Jenkinson B, Josey N, Kruske S. BirthSpace: An evidence-based guide to birth environment design. The University of Queensland: Queensland Centre for Mothers & Babies; 2014.
54.
Foureur M, Davis D, Fenwick J, Leap N, Iedema R, Forbes I, et al. The relationship between birth unit design and safe, satisfying birth: developing a hypothetical model. Midwifery. 2010;26(5):520–5.PubMedCrossRef
55.
Afsana K, Rashid SF. The challenges of meeting rural Bangladeshi women’s needs in delivery care. Reprod Health Matters. 2001;9(18):79–89.PubMedCrossRef
56.
Øxnevad M. Perceptions and practices related to home based and facility based birth. Qual Stud Agemssa. 2011.
57.
Christiaens W, Bracke P. Assessment of social psychological determinants of satisfaction with childbirth in a cross-national perspective. BMC Pregnancy Child. 2007;7(1):26.CrossRef
58.
Mosallam M, Rizk DE, Thomas L, Ezimokhai M. Women's attitudes towards psychosocial support in labour in United Arab Emirates. Arch Gynecol Obstet. 2004;269(3):181–7.PubMedCrossRef
59.
Hassan-Bitar S, Wick L. Evoking the guardian angel: childbirth care in a Palestinian hospital. Reprod Health Matters. 2007;15(30):103–13.PubMedCrossRef
60.
Kabakian-Khasholian T, El-Nemer A, Bashour H. Perceptions about labor companionship at public teaching hospitals in three Arab countries. Int J Gynecol Obstet. 2015;129(3):223–6.CrossRef
61.
Khresheh R. Support in the first stage of labour from a female relative: the first step in improving the quality of maternity services. Midwifery. 2010;26(6):e21–e4.PubMedCrossRef
62.
Jallow IK, Chou Y-J, Liu T-L, Huang N. Women's perception of antenatal care services in public and private clinics in the Gambia. Int J Qual Health Care. 2012;24(6):595–600.PubMedCrossRef
63.
Tetui M, Ekirapa EK, Bua J, Mutebi A. Quality of Antenatal care services in eastern Uganda: implications for interventions. Pan Afr Med J. 2012;13(1).
64.
Hasan A. Patients satisfaction with maternal and child health services among mothers attending the maternal and child health training Institute in Dhaka. Bangladesh: Mahidol University; 2007.
65.
George A. Quality of reproductive care in private hospitals in Andhra Pradesh: Women's perception. Economic and Political Weekly. 2002;37(17):1686–92.
66.
Simbar M, Ghafari F, Tork Zahrani S, Alavi MH. Assessment of quality of midwifery care in labour and delivery wards of selected Kordestan medical Science University hospitals. Int J Health Care Qual Assur. 2009;22(3):266–77.PubMedCrossRef
67.
Melese T, Gebrehiwot Y, Bisetegne D, Habte D. Assessment of client satisfaction in labor and delivery services at a maternity referral hospital in Ethiopia. Pan Afr Med J. 2014;17.
68.
Jenkinson B, Josey N, Kruske S. BirthSpace: an evidence-based guide to birth environment design: Queensland Centre for Mothers & babies, The University of Queensland; 2013.
69.
Newburn M, Singh D. Creating a better birth environment. Br J Midwifery. 2003;11:714.CrossRef
70.
Oweis A, Abushaikha L. Jordanian pregnant women's expectations of their first childbirth experience. Int J Nurs Pract. 2004;10(6):264–71.PubMedCrossRef
71.
Kridli SA-O, Ilori OM, Goeth J. Health beliefs and practices of Qatari women: a qualitative study. Avicenna. 2012;2012(1).
Metadata
Title
Jordanian women’s experiences and constructions of labour and birth in different settings, over time and across generations: a qualitative study
Authors
Suha Abed Almajeed Abdallah Hussein
Hannah G. Dahlen
Olayide Ogunsiji
Virginia Schmied
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2020
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-020-03034-3

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