Women's experiences of pregnancy, childbirth, and the postnatal period in The Gambia: a qualitative study.

OBJECTIVE In sub-Saharan African countries, there are unique cultural factors and adverse physical conditions that contribute to women's experiences of pregnancy and birth. The objective of this study was to qualitatively explore women's experiences of pregnancy, childbirth, the postnatal period, and maternal psychological distress in The Gambia. DESIGN AND METHODS Semi-structured interviews were carried out with 55 women who had given birth within the previous year. RESULTS Thematic analysis identified five themes: (1) transition to adulthood, (2) physical difficulties, (3) value of children in relation to others, (4) children as a strain, and (5) going through it alone. The results suggest that having a child is a defining point in women's lives associated with happiness and joy. However, women also described situations which could lead to unhappiness and distress in the perinatal period. A child conceived out of wedlock or a baby girl can be sources of distress because of negative cultural perceptions. The strain of having a child, particularly the additional financial burden, and minimal support from men were also a concern for women. Finally, women recognized the danger associated with delivery and expressed recurrent worries of complications during childbirth which could result in the death of them or the baby. CONCLUSIONS Further research is needed to identify women vulnerable to psychological distress so that health services and target interventions can be developed accordingly.

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