An exploration of the psycho-social experience of mothers who gave birth prematurely in a low socio-economic context in North West
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Premature birth is increasing globally. It affects an infant’s general, psychological, brain and social development on a short- and long-term basis. Mothers are reported to experience a range of negative emotional outcomes, post-partum depression, post-traumatic stress symptomology, anxiety and depression. Premature birth and separation at birth negatively affect the development of the motherhood identity, which begins when a mother is pregnant and continues to develop after giving birth. Premature birth, as well as the emergence of these emotional difficulties in mothers, affect the normal bonding process between mother and child. Premature birth is prevalent in developing countries like South Africa. The majority of premature births in South Africa are recorded in public institutions which service populations from low socio-economic contexts. Premature birth that occurs in such settings may have the added burden of a lack of resources, unemployment and poverty. While this is so, there is a lack of research studies in developing contexts aimed at understanding the experience of premature birth for mothers. This study aimed to explore the psycho-social experiences of giving birth prematurely in a low socio-economic context. The study conducted a qualitative research study using a phenomenological design. A purposive sample of mothers who gave birth prematurely in public hospitals in the North West Province was used. In-depth interviews were conducted with seven participants after informed consent was sought. Trustworthiness was ensured by implementing the strategies of credibility, transferability, dependability and confirmability. Ethical principles such as autonomy, confidentiality and a distress protocol were adhered to throughout the research process. Participants had access to psychological debriefing if they needed it. Thematic analysis according to Clarke and Braun was used to analyse the data. Two main themes in the experiences of mothers who gave birth prematurely became apparent, namely psychological experiences and social experiences. Psychological experiences included experiences of psychological turmoil, disruption in the development of the mother identity, and ambivalent experiences towards the child. Social experiences included the pertinence of paternal support, ambivalent experiences towards the extended family, support from medical and nursing staff and the network of support from other mothers with infants born prematurely. The socio-economic context of the mothers did not seem to make a difference in how they experienced premature birth, more so because the mothers were allowed to stay with their infants in the hospitals at some stage in the hospitalisation. Findings appear to suggest that mothers who give birth prematurely in a low socio-economic context experience the same psychological responses and need the same social relationships as reported in the literature. Mothers are more psychologically distressed during the early stages after giving birth and while the child is in the neonatal intensive care unit (NICU). It is thereby recommended that mothers who give birth prematurely in a public hospital be identified and referred for supportive psychotherapy during the early stages post-partum. Also, formal support groups should be facilitated to enhance their support. Mothers who are at risk of premature birth should be prepared for the outcome of the birth.
- Health Sciences