I was really, really happy! Because at least I did not go through surgery for nothing - Exploring women’s experiences with caesarean birth and care related to pregnancy, childbirth and post-partum period in Sierra Leone, a qualitative study

Abstract

Introduction: Little research is found on birth experiences in general and caesarean birth experiences in particular from Sierra Leone. The aim of this study was to explore the birth experiences of women giving birth with caesarean section, and their experiences with care during pregnancy, birth and post-partum period. Methods: A qualitative method based on phenomenology was chosen. 16 women purposefully selected from participants in a PhD study on maternal and perinatal outcome of caesarean section were interviewed about their experiences and the interviews were audio-taped, transcribed and analysed using Systematic Text Condensation as described by Malterud. Results: Four main themes were identified: Pain, Fear, Coping strategies and Support. The women experienced both labour pain and post-operative pain in relation to the birth. They also experienced fear of dying and fear of the life of their babies. The pain and fear was dealt with using different coping strategies. The women reported to receive both practical, financial and emotional support from their social network. A few situations with neglect from health care staff was mentioned. The health care workers gave practical care, but were also described to give information and comfort. Conclusion: Women in Sierra Leone are happy to survive caesarean section and are generally satisfied with the care they receive in pregnancy, childbirth by caesarean and post-partum period. However, the importance of individualized health information and emotional support from staff must be emphasized to make the situation more comprehensible and manageable for the women. The presence of a relative in the theatre and the opportunity to discuss their experiences with a health care worker is suggested. Further research on birth experiences both after vaginal births as well as after C/S with complications and/or loss of child is needed.