Understanding the expectations and experiences of women during facility-based childbirth in Eastern Uganda: What do women want during childbirth?

Introduction: Globally, an increase in facility-based childbirth is associated with provision of care that may not align with the expectations of women. The study was conducted to explore expectations of women regarding intrapartum care and whether these expectations aligned with their experiences of care during a facility-based childbirth.

Methods: A qualitative descriptive study was conducted among women who had given birth. We conducted 18 in-depth interviews to explore women's expectations, and preferences during childbirth. Women were also interviewed to explore their childbirth experiences, especially to determine whether their experience of care matched their expectations.

Results: We identified two themes: 1) What women want during intrapartum care and 2) What women received during intrapartum care. Most women prioritised maternal and neonatal survival during intrapartum care. Secondly, women wanted services to be available during childbirth. These included availability of adequate medicines, supplies, and healthcare providers. Thirdly, women who were scheduled for caesarean sections yearned for labour pain relief and postoperative pain relief after birth. Lastly, women wanted respectful maternity care and to give birth in clean facilities. Women who desired for positive birth outcomes including normal births noted that those expectations were met even among those who had caesarean births. Participants noted that medicines and supplies were available for them except for some supplies that were required for caesarean section. Women were surprised to receive respectful care despite hearsay stories of mistreatment in facilities, while the facilities were seen to be clean and hygienic. Although women desired pain relief for labour and postoperative pain, they perceived inadequate pain relief during and after operation.

Conclusion: Women had low expectations of care. Women's expectations were focussed on the bare minimum of maternal and neonatal survival. Women's expectations for availability of medicines, and optimal pain relief were not adequately met during childbirth. Addressing all the expectations of women during childbirth may promote positive childbirth experience, satisfaction and skilled birth attendance.