‘They just told me to go to theatre’: Women’s Lived Experiences and Support Needs Following Emergency Caesarean Section in Kawempe National Referral Hospital.

Abstract

Abstract Background Globally, Caesarean Section (CS) delivery is estimated at 21.1%, has tripled from 7% in 1990, and is projected to reach 28.5% by 2030. In Kawempe National Referral Hospital (KNRH), 43% of women delivered by CS in 2022, and 95% of them were a result of emergency caesarean section (EmCS). However, the lived experiences and support needs of women following CS are not explored, despite knowledge of challenges associated with CS compared to vaginal birth. Objective To explore the lived experiences and support needs of women following emergency caesarean section in Kawempe National Referral Hospital. Methods A phenomenological inquiry was conducted in the post-natal clinic of KNRH among women reviewed on their 6th week following EmCS, and health workers as Key informants (KIs) in KNRH. In-depth audio-recorded interviews for women and KI interviews were conducted. The audio records were transcribed verbatim and analysed using deductive but largely inductive thematic techniques. Results Twenty (20) in-depth interviews and six (6) KI interviews were conducted between June and July 2023. The Mean age of the women was 27.95 years. Most women highlighted negative experiences such as fear of losing their lives during the surgery, poor pain control, and unsatisfactory hospital care such as delays in intervention, poor communication, feelings of discrimination and neglect and informal hospital charges. Conversely, successful surgery that saved their lives and that of their babies, presence of companionship and confidence in being managed by qualified staff in a national referral hospital were highlighted. Both the women and KIs expressed the need for adequate pre-operative care, financial resources, adequate pain control, and quality time for interaction with health care providers to improve care during EmCS. Conclusion Following EmCS, women have both positive and negative experiences at individual, relationship and health care levels. Positive experiences include successful surgery, presence of a companion and being managed in a national referral hospital. However, negative experiences included fear of death for mother and baby, poor pain control, poor communication and informal hospital charges. Financial support, companionship and information on indications for surgery and other interventions were the support needs expressed by the women.