Childbirth-choice facilitation experiences among women in selected public healthcare facilities in Namibia

To describe childbirth-choice facilitation through the experiences of women, and explore women's views on their experiences of childbirth-choice facilitation.

This qualitative exploratory study included 12 women who gave birth in selected public hospitals in different parts of Namibia during the study period. Purposive sampling was adopted to ensure that participants had sufficient knowledge of the subject under study. The research employed individual semi-structured in-depth interviews to understand women's experiences during childbirth facilitation. Data analysis followed the six steps as proposed by Creswell: preparation and organisation of data, exploration and coding of data, coding and building descriptions of the themes, presenting and reporting findings, interpreting the findings and validation of the accuracy of findings.

Women's choices on type of childbirth were assumed as they did not receive full information pertaining to different modes. The research findings were grouped into two main themes and five sub-themes, as follows: childbirth-choice experience (lack of choice, lack of shared decision-making) and information-giving (information sources, preferred information, timing of information-giving). Women expressed that they had limited knowledge and/or information pertaining to types of childbirth as midwives provided little information about how they would give birth. The women also indicated that healthcare professionals made decisions for them without any clear explanation, and that they received information when it was too late and they were unable to process it.

Women who gave birth in public hospitals reported a lack of choice regarding type of childbirth and a lack of shared decision-making. They would have preferred to receive balanced information about types of childbirth in advance in order to make informed decisions.

Health professionals need to provide information on types of childbirth to women early in antenatal care so that they understand the choices and can give informed consent regarding their chosen mode when the time comes. Previous experiences of women need to be solicited to guide the facilitation of current or subsequent pregnancies as a way of ensuring women-centred care.