Experiences of mothers who give birth before arrival at the birthing unit

Abstract

The purpose of this research was to explore and to describe the experiences of mothers who give birth before arrival at a maternity unit in the Nelson Mandela Bay Municipal area in South Africa to enhance support and healthcare provided to them by healthcare providers. The study used a qualitative research design and implemented explorative, descriptive and contextual approaches. Birth-before-arrival at the maternity unit was found to be an experience with diverse emotional reactions, namely embarrassment, concern, anxiety, anger, but also in some cases the participants were comfortable with giving birth at home. Another challenging experience was the delay of paramedics in responding and arriving following a call-out. Some midwives were experienced to be unsupportive at the maternity unit by showing no compassion, and not providing the necessary privacy as expected. Recommendations for midwifery practice focused on improving the health education of pregnant women with regard to danger signs during pregnancy, signs of labour, a birth companion, birth packages, emergency numbers to call if in labour, and in-service education for the emergency response teams to make them aware of the implications of a delayed response to a call of a woman in labour. It is also recommended to deploy a sufficient number of midwives for community service in addition to those that are in labour wards. There appeared to be an urgent need for collaboration between managers and midwives and the emergency response teams to review transport-related policies and to enhance communication processes between these two departments.