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Sensitive and responsive caregiving is a critical protective factor for children in Sub-Saharan Africa (SSA) during their first 1000 days of life. Health initiatives may benefit from evaluating the experience of caregivers in SSA to understand their parenting experiences. This study utilized linguistic analysis to gain insight into the lived experience of 19 Sesotho-speaking mothers of infants aged 18–30 months in low-income areas of Mangaung, Free State, South Africa. Women were asked the same set of questions about their child's first 1000 days of life, and we used LIWC (Linguistic Inquiry and Word Count) LIWC to evaluate the perspectives of mothers in SA compared to published LIWC norms. Analyses revealed word use patterns associated with psychological processes such as negative affect, social processes, anger and anxiety. Findings are discussed within the context of Sesotho culture to aid in the future intervention development for this vulnerable population. This study is important because it yields important information about the subjective experience of an understudied critical population of mothers in SSA. Further, this study points to future directions for the field of understanding the impact of motherhood on women in low resource settings. [ABSTRACT FROM AUTHOR]

This study aims to document the cultural significance of vertical birthing positions and knowledge of easing complicated deliveries among the Porja hilly tribal group, Visakhapatnam district, Andhra Pradesh, India. With the purposive sampling method, 31 postpartum mothers were selected on the inclusion criteria of having been given childbirth in the last six months. The socio-demographic profile of the respondents was presented to understand the socio-cultural living conditions. The qualitative data collection involved 31 face-to-face in-depth interviews with postpartum women and two focus group discussions involving six to eight traditional birth attendants (TBAs) on the cultural efficacy of upright positions. Handwritten transcripts of the interviews and conversations were transcribed and coded into themes and categories. Qualitative themes reveal that the pregnant women with anaemia and morbidity conditions had been exposed to maternal distress and foetal distress (breathing problems and loss of consciousness) but had managed by adopting immediate alternative vertical birthing positions with the suggestion of TBAs. The findings suggest that vertical birth positions are age-old childbirth customs which have been adopted as as a priority option by labouring women, especially in socio-economically disadvantaged societies where medical facilities are unavailable. [ABSTRACT FROM AUTHOR]

Introduction: Despite the emphasis on more systematic and high-quality health care services in the maternal period, a high maternal mortality rate in developing countries is still reported. North Korea, one of the closed countries in the world, is no exception. This study aimed to explore the maternal health experiences in North Korea. Methodology: Qualitative content analysis suggested by Graneheim and Lundman was used to analyze the data of 10 female North Korean defectors. Results: Three categories were derived: pregnancy without self-determination rights, a huge gap between the policies on maternal protection and the reality, and discriminatory childbirth and postpartum care. The theme was "perilous existence of maternal health." Discussion: We highlighted the need for awareness of maternity protection led by health care professionals such as nurses to guarantee Universal Health Coverage as a human right for North Korean women. [ABSTRACT FROM AUTHOR]

Despite a relatively permissive abortion law, women in the Netherlands encounter difficulties in accessing abortion care. Little is known about their experiences. This study explores women's experiences with (online) abortion services and relevant health professionals' experiences delivering care, with the goal of identifying key barriers encountered by abortion-seekers in the Netherlands. An exploratory qualitative research design with a constructivist approach and an abbreviated grounded theory method was used. Interviews with 20 women who had had an abortion and 14 health professionals who provide abortion care, and 200 emails of women seeking abortion care through the non-governmental organisation Women on Web, were coded inductively and deductively (using the Candidacy Framework) thereby generating themes. Abortion-seekers faced barriers including: (i) burden of taboo, (ii) vulnerability (emotional, financial, and social), (iii) health professional evaluation and (iv) disempowerment and distress. The overarching theme was women's lack of autonomy in access to abortion care. The key barriers to abortion access in the Netherlands are the institutionalisation of taboo in abortion law and care, complex candidacy regulations, lack of permeability for certain marginalised groups, and women's inability to speak openly about abortion. To increase the permeability of abortion care, and thereby women's autonomy, legislators and policy-makers must trust women to make their own reproductive decisions and avoid actions that stigmatise abortion and hinder access to care, while actively developing systemic support for vulnerable groups. [ABSTRACT FROM AUTHOR]

Background: Equitable access to services that promote health and wellbeing is an important component of social justice. A community-engaged participatory qualitative study was conducted in Flint, Michigan, USA, to understand the needs of special populations (young women, perinatal women and new mothers, older women, women with disabilities, and LGBTQIA women) and elicit their ideas about solutions. Methods: In-depth interviews (n = 100) were conducted. Participants were either women living in the Flint area, human service providers in the area, or both. A team of community and academic coders analyzed the data using an a priori framework. Results: Participants identified needs of different groups of women and suggested ways to address them. Access to healthy food, reducing healthcare costs, and improving transportation, job opportunities and affordable quality housing were crosscutting themes across all groups of women. Mentoring support was said to protect vulnerable young women from the risk of human trafficking. Older women were said to gain a sense of purpose, build their social support and reduce their loneliness by engaging in mentoring younger women. Women with disabilities were reported to benefit from infrastructure accessibility and authentic inclusion in all areas of life. Providing help that considers their dignity, pride and self-worth were suggested. LGBTQIA women were reported to have housing needs due to discrimination; mostly turned down as renters and can be rejected from faith-based homeless shelters. LGBTQIA women would also benefit from increased sensitivity among healthcare providers. For all groups of women, streamlining access to social services and other resources, building social support networks and increasing awareness about existing resources were recommended. Conclusion: Efforts directed towards improving women's health and wellbeing should include perspectives and suggestions of diverse groups of women from the community. Acting on suggestions that emanate from the community's lived experiences may reduce inequalities in health and wellbeing. [ABSTRACT FROM AUTHOR]

Background: Despite substantial progress on maternal and child mortality, neither the Millennium Development Goal 4 nor 5 targets could be met. The global maternal mortality ratio declined by 44% between 1990 and 2015, short of the targeted 75% fall. Objectives: The objective of the study is to evaluate the maternal health services being provided to the high-risk mothers (HRMs) of Bhavnagar district. Methodology: It was a cross-sectional study conducted among the HRMs of Bhavnagar district during the period from March 2017 to August 2018. A total of 90 HRMs were selected and interviewed. Results: All the HRMs were measured for blood pressure and weight; tested for hemoglobin, blood group, and HIV; and examined for pedal edema. None of the HRMs were tested for sickle cell anemia. In the best performing primary health centers (PHCs), all the HRMs were tested for venereal disease research laboratory and hepatitis B surface antigen as against 79.5% of the HRMs from the worst-performing PHCs. About 47.7% of the HRMs from the worst-performing PHCs and 13.3% of the HRMs from the best-performing PHCs made <4 antenatal care (ANC) visits. Conclusions: For most of the ANC services, reason for nonreceipt of the service as given by the HRMs was "service not offered." [ABSTRACT FROM AUTHOR]

Purpose: To explore the feasibility of infant hearing screening from a developing country context. Methods: A descriptive research design was employed, using a combination of surveys, questionnaires and face-to-face semi-structured interviews; as well as conduction of audiological measures such as otoacoustic emissions (OAEs) and automated auditory brainstem responses (AABR) during hearing screening. Participants comprised low-risk neonates, high-risk neonates and primary health care nursing managers. Results: Findings indicated that (1) screening at the Midwife Obstetric Unit 3-day assessment clinic may be more practical; (2) screening at primary health care clinics is not feasible until the identified barriers are addressed and; (3) factors such as ambient noise levels, availability of space for screening and time of discharge influence the practicability and efficiency of screening within a hospital context. Conclusion: There are a number of factors which influence the practicability and efficiency of newborn hearing screening. Each of these factors may vary depending on the level of healthcare setting and may either facilitate or act as barriers toward the implementation of newborn hearing screening in the South African context. [ABSTRACT FROM AUTHOR]

Disadvantaged childbearing women experience barriers to accessing health and social care services and face greater risk of adverse medical, social and emotional outcomes. Support from doulas (trained lay women) has been identified as a way to improve outcomes; however, in the UK doula support is usually paid-for privately by the individual, limiting access among disadvantaged groups. As part of an independent multi-site evaluation of a volunteer doula service, this study examined women's experiences of one-to-one support from a trained volunteer doula during pregnancy, labour and the post-natal period among women living in five low-income communities in England. A mixed methods multi-site evaluation was conducted with women (total n = 137) who received the service before December 2012, using a combination of questionnaires ( n = 136), and individual or group interviews ( n = 12). Topics explored with women included the timing and nature of support, its impact, the relationship with the doula and negative experiences. Most women valued volunteer support, describing positive impacts for emotional health and well-being, and their relationships with their partners. Such impacts did not depend upon the volunteer's presence during labour and birth. Indeed, only half (75/137; 54.7%) had a doula attend their birth. Many experienced volunteer support as a friendship, distinct from the relationships offered by healthcare professionals and family. This led to potential feelings of loss in these often isolated women when the relationship ended. Volunteer doula support that supplements routine maternity services is potentially beneficial for disadvantaged women in the UK even when it does not involve birth support. However, the distress experienced by some women at the conclusion of their relationship with their volunteer doula may compromise the service's impact. Greater consideration is needed for managing the ending of a one-to-one relationship with a volunteer, particularly given the likelihood of it coinciding with a period of heightened emotional vulnerability. [ABSTRACT FROM AUTHOR]

• Adverse childhood events (ACEs) continue to impact the transition to motherhood. • Relationships with close family members were generally strained. • Treatment should include the establishment of formal sources of social support. • The ability to bond to the baby is sometimes delayed. • Practitioners should be aware of behaviors/cognitions that reflect these delays. The aim of the present study was to gain an understanding of how vulnerable mothers with adverse childhood experiences transition towards motherhood. Semi-structured interviews were conducted with a convenience sample of 15 vulnerable (young) mothers who were residing in a mother-baby home at the time of the study. By means of inductive thematic analyses, a number of themes were identified that characterized the transition to motherhood. The results showed that mothers experienced a number of adversities during childhood which made them aware early on what type of mother they wanted to be for their children. Because of medical complications or involvement of child protective services, the ability to take care and bond with the baby was sometimes delayed. Further, the arrival of the baby was often considered a turning point: to bring change to the life of the mother or a second chance to motherhood. Relationships with their own parents were generally strained and sometimes put on hold to protect oneself. The mothers also mentioned difficulties with accepting and asking for support, their outlook on social support was generally ambiguous. Clinical implications of the results are discussed in the light of traditional care and the theory on ambiguous loss. [ABSTRACT FROM AUTHOR]