Jordanian women's experiences and constructions of labour and birth in different settings, over time and across generations : a qualitative study

Abstract

Many women across the world experience birth as dehumanising and disrespectful and this is particularly so in Middle Eastern countries including Jordan. The increasing evidence of mistreatment during labour and birth has garnered the attention of the World Health Organization (WHO) and Safer Motherhood. The WHO explicitly states that there is an urgent need for more evidence and action on ensuring that maternity care is respectful, maintains women's dignity and offers emotional support. This thesis has two aims: 1. To examine Jordanian women's experiences and constructions of labour and birth in different settings (home, public and private hospitals in Jordan, and Australian public hospitals), over time and across generations. 2. To identify strategies and processes to improve the birthing experiences of women in Jordan from the perspective of birthing women and health professionals. This is a thesis by publication and the findings are presented in four published papers. The first publication reports the outcomes of a meta-ethnographic review of the literature reporting Middle Eastern women's experiences of birth. The second published paper examined Jordanian women's birth experiences across settings and generations. In the third published paper, the concept of privacy is explored. The final paper reports on the second phase of this thesis that aimed to explore perceptions of community women and health professionals about the key concerns and barriers to change, and potential strategies to improve the birthing experiences of women in Jordan. The findings have demonstrated how meanings attributed to labour and birth, particularly the experience of pain, are produced in different settings, providing insights into the institutional management and social context of birth in Jordan and other Middle Eastern countries. The study also demonstrated the impact of the birth environment, interactions with health professionals and a patriarchal health system on women's experience. Action is needed at all levels on policy, education and practice. In the short term, training about compassionate care and human rights in childbirth should be provided to midwifery and medical students at university and in professional development for maternity staff. Hearing Jordanian women's stories may be a very powerful way of informing health professionals and services about the impact of the care they receive and how this can be used to promote practice change.

Date of Award	2021
Original language	English