Good birth narratives : diverse South African women's perspectives

Abstract

BACKGROUND : There is currently a substantial international research focus on issues relating to childbirth distress, traumatic birth and negative birth experiences. Less research attention has been paid to women's narratives or accounts of positive or affirming birth experiences, particularly in the South African context. The aim of this article is to explore the ingredients of a 'good birth' experience from the perspectives of South African women's birth narratives. METHODS : An exploratory, qualitative research design using unstructured interviewing and a narrative methodological framework was used to explore women's perspectives about the ingredients of a 'good birth' experience. Sixty-one participants were obtained via convenience sampling. The sample including 35 low-income black women and 26 middle-class, predominantly white women, aged 18–45 years who had recently given birth to an infant. Thirty-three women gave birth in the public healthcare system, with 25 of these women having vaginal deliveries and eight reporting a caesarean section. Two women had unassisted vaginal births while in transit to public healthcare facilities. Twenty-six women gave birth in the private healthcare system; 15 participants had a planned homebirth with a private midwife, nine had an elective caesarean section, one woman had an emergency caesarean section and another participant gave birth vaginally (with epidural) in a private hospital. FINDINGS : Less than half of the women (n = 26) narrated positive birth experiences. Almost half of the women (n = 30) narrated distressing birth experiences while five women reported neutral birth experiences. This paper focuses only on women's 'good birth' narratives (n = 26). Good and affirming birth narratives were characterized by the following three themes, namely: (1) a sense of presence, (2) physical and ontological safety and (3) respectful care. CONCLUSION : The bodily and corporeal aspects of the birth experience were found to be central to women's 'good birth' narratives. A key conclusion is that maternal healthcare provision needs to be reimagined in ways which acknowledge, centre and respect the unique and vulnerable corporeality of birthing women, regardless of type of birth.