Abstract
BackgroundOverwhelmingly, 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.MethodA 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.ResultsWomen’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.ConclusionsThe 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,
Highlights
Women in Middle Eastern countries experience birth as dehumanising and disrespectful
The findings demonstrate how meanings attributed to labour and birth, 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
There is evidence in high income countries (HIC) that women are being traumatised by their experience within maternity care systems, where intervention in birth is high and medicalisation is impinging on choice and humanised care [11,12,13]
Summary
Women in Middle Eastern countries experience birth as dehumanising and disrespectful. We know from studies in high income countries that the place of birth and the support women receive from their care providers profoundly impacts on women’s birth experience [14,15,16]. Studies in countries such as the United States, United Kingdom, and Australia are reporting that mistreatment during labour and birth is driving some women to seek alternatives and for some, this is to birth outside of the mainstream maternity system with no health professional present [13, 17, 18]. The hospital represents a riskier place to give birth than birthing at home [12]
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