Women’s experiences of maternal near miss: Qualitative findings from Malawi

Abstract

Objective

This study explored the experiences of women with maternal near miss and their perceptions of the quality of care they received in three facilities in Malawi.

Methods

This study employed a qualitative phenomenological approach. Data were collected using in depth interviews and analysed using thematic content analysis. The data were collected in three hospitals between September and November 2020. The purposively selected participants were 18 women meeting criteria for maternal near miss related to obstetric haemorrhage (6), hypertensive disorders (7), sepsis (2) and ruptured ectopic pregnancy (3).

Results

Women’s experiences of maternal near miss fell under four broad themes; (a) realisation of the near miss; (b) religious beliefs and interpretation of near miss; (c) social and economic aspects of maternal near miss; and d) perceptions of quality of care. Women’s initial emotional responses were fear and anxiety but were soon overshadowed by the fear for their babies’ wellbeing. Most women perceived the care they received as timely, adequate, and respectful, yet many women also expressed that their service providers did not provide an opportunity to openly discuss their condition.

Conclusions

The experience of near miss goes beyond the immediate physical discomforts and has psychological, economic, and social consequences for women and their families. Despite women’s perception of care as respectful, there are still communication gaps with their service providers. Campaigns to improve the communication between providers and patients and their families in situation of severe morbidity warrant consideration.