Rural women's voices revealing perceptions about decisions on where to give birth in Gabon: A qualitative study

This study aimed to clarify the perceptions of rural women about their decisions on where to give birth in Gabon.

This study used a qualitative descriptive design using semi-structured interviews. Study participants were women at least 20 years old and had given birth within the past 2 years. The study area was approximately 25-30 km from the capital of Gabon. Data collection was conducted between May and mid-July 2023. The interview guide was based on the Ottawa Decision Support Framework (ODSF) 2020 model. The data obtained were analyzed using content analysis for "perceptions in deciding the place of birth."

A total of 18 women participated in the study. Six categories of reasons were identified for women's choice of birth location: (1) childbirth environment with physical safety; (2) childbirth environment with psychological safety; (3) physical accessibility; (4) affordable health facilities; (5) concerns about homebirth risks; and (6) unpleasant aspects of the hospital. Items (1)-(4) were the reasons for actively choosing the hospital as a birth location, whereas items (5) and (6) were the reasons for avoiding a place to give birth.

Women positively perceived and chose facilities that offer physical and mental safety, geographic accessibility, and affordable costs. Conversely, an environment where the safety of the mother and the child is threatened and the lack of respectful maternity care by the medical staff served as deterrents to facility use.