Birth preparedness among women in early labor: A qualitative study in Durban, South Africa

Background: The high maternal and neonatal deaths recorded in low- and middle-income countries, particularly in Africa, present a serious challenge. Sub-Saharan countries still record the highest mortality ratio and even the highest in the developing world. It is reported that five major complications such as obstructed labor, unsafe abortion, high blood pressure during pregnancy, hemorrhage, and infection are responsible for this high mortality rate, which could be prevented through birth preparedness program, adequate health education, and information sharing, including the use of social media in attempt to educate every expectant woman regarding birth preparedness. Objective: This study aimed to assess birth preparedness among women in early labor at selected hospitals. Design: A qualitative descriptive approach. Methods: This was a descriptive qualitative research study, conducted among expectant women in early labor and three focus group discussions. Data were collected and analyzed from participants using face-to-face interviews and focus group discussions. The interviews were transcribed verbatim and analyzed using thematic content analysis. Participants for this study were pregnant women in early labor with gestational ages between 36 and 41 weeks, as the study excluded the mothers who were in preterm labor. Results: Nine themes emerged from the data: understanding of birth preparedness, perceived benefits of birth preparedness, women’s responsibilities in birth preparedness, roles of healthcare workers in birth preparedness, timing of birth preparedness activities, women’s choices regarding delivery location, pregnancy complication readiness, sources of information on motherhood and birth preparedness, and barriers to birth preparedness. Several categories emerged under each theme, and the results revealed that understanding of birth preparedness was associated with mental, emotional, financial, and physical preparedness. Participants reported barriers associated with budget limitations, lack of information, healthcare workers’ attitudes, unplanned pregnancies, and cultural beliefs. Healthcare workers were abusive and displayed negative attitudes toward expectant women. Conclusion: Challenges affecting the status of birth preparedness among expectant mothers can be understood and therefore preventable. Interventions need to enforce already existing maternity health protocols and leverage innovation and technology to reduce the morbidity and mortality of pregnant women and neonates.