Exploring the Experiences and Perceptions of Women About Childbirth at Birthing Centers in Karachi, Pakistan

Abstract

Objective:The purpose of this study was to explore the perceptions of women about childbirth experiences at the birthing centers (BCs) in Karachi, Pakistan.Design:A qualitative descriptive exploratory approach was employed using semistructured interviews.Participants:A purposive sample of eight women who had used BCs was enrolled from each site.Findings:Five themes emerged from content analysis including: (a) satisfaction with BC, (b) provision of homely environment, (c) promotion of normalcy, (d) facilitation of family support, and (e) protection of privacy.Key Conclusions:Overall, the findings of the study revealed that women who used BCs were satisfied with the services and the environment provided to them by the midwives during the antenatal, intranatal, and postnatal periods. Most of the women appreciated the privacy offered at the BCs. They considered BCs as a safe, accessible, and affordable option for childbirth and encouraged others in the community to opt for it.Implications for Practice:The findings of this study may help to advocate for births at BCs and provide women-friendly maternity care, by giving choice and control to women during childbirth, providing comfort to women by using fewer medical interventions, and promoting normalcy by attending spontaneous vaginal delivery.

Which low- and middle-income countries have midwife-led birthing centres and what are the main characteristics of these centres? A scoping review and scoping survey

“…Papers from Mexico ( Alonso et al., 2021 ) and Pakistan ( Akhtar et al., 2017 ), described a sliding cost scale, with lower user fees for poorer clients, subsidized through donor funds. In Pakistan, this was contrasted with “fixed” hospital fees.…”

“…Some of the peer-reviewed literature included an attempt to measure the impact of MLBCs, using a variety of outcome measures. Most reported positive outcomes to MLBC births such as low mortality and morbidity rates ( Anonymous, 2012 ; David et al., 2012 ; Moudi and Tabatabaei, 2016 ; Ngongo et al., 2013 ; Progianti et al., 2013 ; Schneck et al., 2012 ), low intervention rates ( Alonso et al., 2021 ; Caldas Nicacio et al., 2016 ; David et al., 2012 ; Ngongo et al., 2013 ; Schneck et al., 2012 ; Wallace, 2019 ) and high quality of care ( Akhtar et al., 2017 ; da Silva et al., 2013 ; David et al., 2012 ; Freitas et al., 2019 ). The main exceptions were the evidence from South Africa of high rates of disrespect and abuse ( Dutton and Knight, 2020 ; Malatji and Madiba, 2020 ; Oosthuizen et al., 2020 , 2017 ; Zitha and Mokgatle, 2020 ), and the evidence from Brazil of some ineffective or potentially harmful practices in MLBCs ( da Silva et al., 2013 ; Freitas et al., 2019 ).…”

Exploring networks of care in implementing midwife-led birthing centres in low- and middle-income countries: A scoping review

“…These used a variety of methods and study designs. From 36 research papers, three used mixed methods [ 20 – 22 ], 16 were qualitative [ 5 , 23 – 37 ], and the remaining 17 used a quantitative design.…”

“…Being responsive to needs includes enabling meaningful interactions with women and their communities to address their individual, cultural and emotional needs and supporting women and their families to feel safe, confident and included in their care. Thirteen papers addressed these needs [ 20 , 23 – 25 , 28 , 29 , 32 – 34 , 38 , 41 , 48 , 50 ].…”

“…Being responsive to needs included privacy and respectful and responsive care provided by midwives which was highly appreciated by clients [ 23 , 32 ]. The provision of high-quality, holistic care within MLBCs increased service utilisation [ 24 , 33 .…”