Narratives of distress about birth in South African public maternity settings: A qualitative study

Objective: to explore the factors associated with negative birth experiences in South African public maternity settings from the perspective of women's birth narratives. Design: an explorative, qualitative research study using a narrative methodological framework and unstructured interviewing. Setting: the city of Cape Town in South Africa. Participants: 33 low-income women aged 18-42 years who had recently given birth to an infant in the public maternity sector. Findings: more than half of the women (n=18) narrated 'narratives of distress' in relation to their birth experiences. One third narrated 'good' birth experiences and four women told minimalistic or neutral birth narratives. This paper reports only on factors associated with women's distress narratives. Narratives of distress were associated with poor quality of intrapartum care and characterised by the following four themes, namely (1) negative interpersonal relations with caregivers, (2) lack of information, (3) neglect and abandonment and (4) the absence of a labour companion. Key conclusions and implications for practice: poor relationships with caregivers emerged as central to women's distress narratives. Interventions aimed at improving interpersonal communication, connection and rapport between caregivers and labouring women are central to improving quality of care in resource-constrained settings. © 2014 Elsevier Ltd.