Birthing in Girar Jarso woreda of Ethiopia

In many African countries, women’s disempowerment and subjugation affect their reproductive health services utilization. This situation becomes even more problematic for women during their vulnerable moments of childbirth. Although copious literature exists on women’s experiences in navigating socio-cultural, religious, economic and structural barriers during childbirth, there is paucity of literature on women’s perceptions of childbirth globally. Extant studies generally focus on health professionals’ and researchers’ perspectives on childbirth. This case study was conducted in two rural communities in Girar Jarso woreda of Ethiopia to explore women’s experiences and perceptions of childbirth. The purpose of this study was to understand the local contexts in which women live and their implications for women’s choice of place of birth and/or birth attendants in Girar Jarso woreda. It is hoped that this study would inform efforts to improve maternity health services delivery and uptake in Ethiopia. This case study was conducted within intersectionality theoretical framework. Data were collected through focus group discussions, in-depth interviews, observation, fieldnotes and cultural interpretations. The data were analyzed and interpreted through social constructionist epistemological lens. This study employed inductive thematic analytical approach. The findings of this study were presented under themes consistent with research questions and were later analyzed and discussed in detail. The findings revealed that institutional birth is gaining popularity in Girar Jarso woreda in the face of socio-cultural, religious, economic, structural and personal barriers. The improvements in institutional birth can be attributed to the Ethiopian government’s persistent efforts to improve maternal, newborn and child health through policies, programs and initiatives. Despite improvements, transportation, health system characteristics, communal decision-making, preference for traditional birth among others, impede efforts to increase institutional birth. This study concluded that women’s experiences and perceptions of childbirth in Girar Jarso woreda are varied. Women’s powerlessness and men’s dominant decision-making position in Ethiopian society affect women’s birth experiences. To improve women’s overall birth experiences, mechanisms need to be established to address patriarchy, women’s rights, transportation challenges, and attitudes of health professionals towards laboring women. The health development program needs reconfiguration to involve men, elderly women and community leaders in reproductive health communication efforts. Efforts should be made to integrate traditional birthing practices into modern obstetric services in the health system. Finally, there is a need for greater collaboration between health extension workers, traditional birth attendants and women development armies in the delivery of community maternity health services