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      Women's Perspectives on Cultural Sensitivity of Midwives During Intrapartum Care at a Maternity Ward in a National Referral Hospital in Zimbabwe

      research-article
      , PhD, MPH, MBA, BSc 1 , , , PhD, MSc, BSc 1 , , PhD, MSc, BSc 2 , , MSc, BSc 1
      SAGE Open Nursing
      SAGE Publications
      intrapartum care, labor and delivery, culture-sensitive care, midwives, women

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          Abstract

          Introduction

          Midwives attend intrapartum women of diverse ethnic backgrounds who each bring their cultural beliefs into the labor and delivery rooms. The International Confederation of Midwives has recommended providing culturally appropriate maternity care in its quest to increase skilled birth attendance and subsequently improve maternal and newborn health.

          Objective

          This study aimed to examine midwives’ cultural sensitivity during intrapartum care from women's perspectives, and how this relates to women's satisfaction with maternity care services.

          Methods

          A qualitative phenomenological design was employed. Two focus group discussions were conducted with 16 women who had delivered in the labor ward of the selected national referral maternity unit. An interpretive phenomenological approach was used to analyze the data.

          Results

          This study revealed ineffective midwife–woman collaboration that excludes the incorporation of women's cultural beliefs in the design of maternity care plans. Emotional, physical, and informational support in the care provided to women during labor and childbirth was found to be incompetent. This suggests that midwives are not sensitive to cultural norms and do not provide woman-centered intrapartum care.

          Conclusion

          Various factors implying midwives’ lack of cultural sensitivity in their provision of intrapartum care were identified. Resultantly, women's expectations of labor are not met and this could negatively affect future maternity care-seeking behaviors. This study's findings provide policy makers, midwifery program managers and implementers with better insights for developing targeted interventions to improve cultural sensitivity for the delivery of respectful maternity care. Identifying factors that affect the implementation of culture-sensitive care by midwives could guide the adjustments required in midwifery education and practice.

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          Most cited references34

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          Comparison of Convenience Sampling and Purposive Sampling

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            The Mistreatment of Women during Childbirth in Health Facilities Globally: A Mixed-Methods Systematic Review

            Background Despite growing recognition of neglectful, abusive, and disrespectful treatment of women during childbirth in health facilities, there is no consensus at a global level on how these occurrences are defined and measured. This mixed-methods systematic review aims to synthesize qualitative and quantitative evidence on the mistreatment of women during childbirth in health facilities to inform the development of an evidence-based typology of the phenomenon. Methods and Findings We searched PubMed, CINAHL, and Embase databases and grey literature using a predetermined search strategy to identify qualitative, quantitative, and mixed-methods studies on the mistreatment of women during childbirth across all geographical and income-level settings. We used a thematic synthesis approach to synthesize the qualitative evidence and assessed the confidence in the qualitative review findings using the CERQual approach. In total, 65 studies were included from 34 countries. Qualitative findings were organized under seven domains: (1) physical abuse, (2) sexual abuse, (3) verbal abuse, (4) stigma and discrimination, (5) failure to meet professional standards of care, (6) poor rapport between women and providers, and (7) health system conditions and constraints. Due to high heterogeneity of the quantitative data, we were unable to conduct a meta-analysis; instead, we present descriptions of study characteristics, outcome measures, and results. Additional themes identified in the quantitative studies are integrated into the typology. Conclusions This systematic review presents a comprehensive, evidence-based typology of the mistreatment of women during childbirth in health facilities, and demonstrates that mistreatment can occur at the level of interaction between the woman and provider, as well as through systemic failures at the health facility and health system levels. We propose this typology be adopted to describe the phenomenon and be used to develop measurement tools and inform future research, programs, and interventions.
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              Quality of care for pregnant women and newborns-the WHO vision.

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                Author and article information

                Journal
                SAGE Open Nurs
                SAGE Open Nurs
                SON
                spson
                SAGE Open Nursing
                SAGE Publications (Sage CA: Los Angeles, CA )
                2377-9608
                27 February 2023
                Jan-Dec 2023
                : 9
                : 23779608231160476
                Affiliations
                [1 ]Department of Nursing and Midwifery, Faculty of Medicine, Ringgold 108243, universityNational University of Science and Technology; , Ascot, Bulawayo, Zimbabwe
                [2 ]Department of Environmental Health, Faculty of Environmental Science, Ringgold 108243, universityNational University of Science and Technology; , Ascot, Bulawayo, Zimbabwe
                Author notes
                [*]Fennie Mantula, 60 Windermere Road, Morningside, Bulawayo, Zimbabwe. Email: fennie.mantula@ 123456nust.ac.zw
                Author information
                https://orcid.org/0000-0003-3609-8006
                Article
                10.1177_23779608231160476
                10.1177/23779608231160476
                9974627
                36875792
                7d738d21-acd7-4f8a-ac2c-4e259b1f8221
                © The Author(s) 2023

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 12 September 2022
                : 12 February 2023
                Categories
                Original Research Article
                Custom metadata
                ts19
                January-December 2023

                intrapartum care,labor and delivery,culture-sensitive care,midwives,women

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