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Avoiding a 'big' baby : local perceptions and social responses toward childbirth-related complications in Menabe, Madagascar
- Source :
- Social science & medicine, Social science & medicine, Elsevier, 2018, 218, pp.52-61. ⟨10.1016/j.socscimed.2018.10.002⟩
- Publication Year :
- 2018
-
Abstract
- International audience; In Madagascar, a country where over 60% of deliveries are not attended by a healthcare professional, late or inadequate responses to complications during childbirth account for a great number of maternal deaths. In this article, we analyse local perceptions of birth-related risks and strategies used to avoid these risks or manage complications of childbirth. We conduct this analysis in light of the social meanings of childbirth and the social expectations placed upon women in a context of socioeconomic vulnerability and a challenged public health system. We conducted two separate studies in the district of Morondava (Menabe region) in June 2014 and March 2015, comprising semi-directive interviews with 111 people (59 mothers, 18 members of their immediate en-tourage and 34 institutional or healthcare stakeholders), and eight focus groups discussions-two with community leaders, and six with fathers. The results show that the social pressure exerted on women to give birth without complications leads them to practices aimed at avoiding a "big" baby including dietary restrictions, physical activity, and refusal of iron supplementation intake. During pregnancy, women are usually accompanied by a traditional birth attendant or matron (reninjaza). Further, they use the public health system by attending antenatal consultations. However, women are reluctant to deliver in a health facility, where the practices of health professionals are in discordance with the social realities of women and local beliefs around childbirth. If complications arise, they are explained by social causes. The parturient woman is only taken to a healthcare facility after carrying out rituals and if the problems do not resolve themselves. These findings support recommendations to reduce the cultural distance between health workers and childbearing women, strengthen the collaborations with reninjazas, and inform women and their decision makers (mother, reninjaza, spouse) about nutrition during pregnancy and signs of complications.
- Subjects :
- Adult
Maternal mortality
medicine.medical_specialty
Health Knowledge, Attitudes, Practice
Health (social science)
Pregnant women's care pathways
Local knowledge
[SHS.ANTHRO-BIO]Humanities and Social Sciences/Biological anthropology
Mothers
Social issues
03 medical and health sciences
0302 clinical medicine
History and Philosophy of Science
Health facility
Nursing
Pregnancy
Health care
medicine
Madagascar
Childbirth
Humans
030212 general & internal medicine
Qualitative Research
[SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health
030219 obstetrics & reproductive medicine
[SHS.SOCIO]Humanities and Social Sciences/Sociology
business.industry
Public health
Focus Groups
Delivery, Obstetric
Focus group
Pregnancy Complications
Spouse
Anthropological approach
Childbirth-related complications
Female
Perception
Traditional birth attendant
Psychology
business
Subjects
Details
- Language :
- English
- ISSN :
- 00377856
- Database :
- OpenAIRE
- Journal :
- Social science & medicine, Social science & medicine, Elsevier, 2018, 218, pp.52-61. ⟨10.1016/j.socscimed.2018.10.002⟩
- Accession number :
- edsair.doi.dedup.....eac96077e376ea2226a7efd6dc2d78d1