Navigating the Perils of Pregnancy and Childbirth Among Youth in La Pointe, Haiti: Insights Captured Through Community Photovoice Research.

IF 2.4 2区 医学 Q2 INFORMATION SCIENCE & LIBRARY SCIENCE
Tonya A MacDonald, Marie-Carmèle Charles, Olès Dorcely, Françoise D Volcy Bonne Anney, Medge Dona Mular, Lovenska Sylvestre, Rose Andrele Bien Aimé, Elizabeth K Darling, Saara Greene, Sandra Moll, Carmen Logie, Lawrence Mbuagbaw
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Abstract

In Haiti, surviving pregnancy and childbirth is especially tenuous for young women, who are already marginalized. One of the four leading causes of death for women 20-24 years old is pregnancy- or childbirth-related. An important gap remains regarding youth perspectives of maternal health and well-being within their communities. We conducted a community-based participatory research study using Photovoice to understand the lived experiences of 17 young women from La Pointe, Haiti, and its surrounding rural communities, who survived a maternal near-miss, a grave obstetric event that one narrowly escapes. Youth participants took photographs and participated in individual interviews and focus groups to represent and share their pregnancy and birthing experiences. Visual and narrative data were analyzed by participants and our community research team using reflexive thematic analysis. The five main themes represent a perilous maternal journey. The themes included (a) the social context youth are embedded within, (b) structural, systemic and political forces youth face, (c) pain and suffering throughout youth maternal experiences, (d) search for support during the maternal trajectory, and (e) youth-generated solutions for improved maternal health and well-being. Our findings amplify youth voices on the pressing need to address multiple, intersecting issues that shape maternal health and well-being for all women with particular attention to the needs of young women. Understanding the experiences of Haitian youth survivors of maternal near-misses can inform research, practice, and policy to curb maternal deaths and maternal near-misses among young women within low-resource settings.

在海地拉波因特的青年中导航怀孕和分娩的危险:通过社区照片语音研究捕获的见解。
在海地,对于已经被边缘化的年轻妇女来说,在怀孕和分娩中幸存下来尤其脆弱。20-24岁妇女死亡的四大主要原因之一是与怀孕或分娩有关。在青年对其社区内孕产妇保健和福祉的看法方面,仍然存在重大差距。我们利用Photovoice进行了一项以社区为基础的参与性研究,以了解来自海地拉波因特及其周边农村社区的17名年轻女性的生活经历,这些女性在一次险情分娩中幸免于难。青年参加者拍摄照片,并参加个别访谈和焦点小组,以代表和分享他们的怀孕和分娩经历。参与者和我们的社区研究团队使用反身性主题分析来分析视觉和叙事数据。这五个主题代表了一个危险的母亲之旅。主题包括(a)青年所处的社会背景,(b)青年所面临的结构性、系统性和政治力量,(c)青年孕产经历中的痛苦和折磨,(d)在孕产过程中寻求支持,以及(e)青年为改善产妇健康和福祉提出的解决办法。我们的研究结果放大了青年的声音,表明迫切需要解决影响所有妇女孕产妇保健和福祉的多重交叉问题,特别关注年轻妇女的需求。了解海地青年孕产妇未遂幸存者的经历,可以为研究、实践和政策提供信息,以遏制低资源环境下年轻妇女的孕产妇死亡和孕产妇未遂事件。
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来源期刊
CiteScore
6.80
自引率
6.20%
发文量
109
期刊介绍: QUALITATIVE HEALTH RESEARCH is an international, interdisciplinary, refereed journal for the enhancement of health care and to further the development and understanding of qualitative research methods in health care settings. We welcome manuscripts in the following areas: the description and analysis of the illness experience, health and health-seeking behaviors, the experiences of caregivers, the sociocultural organization of health care, health care policy, and related topics. We also seek critical reviews and commentaries addressing conceptual, theoretical, methodological, and ethical issues pertaining to qualitative enquiry.
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