LoPoni Charles Taban, Rujumba Joseph, Ssekatawa Wycliffe, Adupet Martyn, Kashesya Jolly Beyeza, Sule Ismail, Nakalembe Miriam
Department of Obstetrics and Gynaecology, College of Health Sciences, Makerere University, Kampala, Uganda.
Department of Paediatrics and Child Health, School of Medicine, Makerere University, Kampala, Uganda.
BMC Pregnancy Childbirth. 2025 Jul 19;25(1):772. doi: 10.1186/s12884-025-07833-4.
Globally, the Caesarean Section (CS) rate is estimated at 21.1% and tripled from 7% in 1990 and projected to reach 28.5% by 2030. In Kawempe National Referral Hospital (KNRH) in Kampala, Uganda, 43.0% of women gave birth by CS in 2022 and 95% of the procedures were emergency caesarean sections (EmCS). The experiences and support needs of women following CS, however, were not explored, despite knowledge of challenges associated with CS compared to vaginal birth (VB).
To explore the experiences and support needs of women following emergency caesarean section in Kawempe National Referral Hospital.
A phenomenological inquiry was conducted in the postnatal clinic of KNRH among women six weeks following EmCS and health workers as Key informants (KIs) in KNRH. In-depth audio-recorded interviews with women after CS and KI interviews were conducted. The audio records were transcribed verbatim and analysed using deductive, but largely inductive thematic techniques.
Twenty in-depth interviews and six KI interviews were conducted between June and July 2023. Average age of the women was 27.95 years. Most women highlighted negative experiences such as fear of losing their lives during surgery, poor pain control and unsatisfactory hospital care such as delays in intervention, poor communication, feelings of discrimination and neglect and informal hospital charges. Conversely, successful surgery that saved their lives and that of their babies, presence of a companion after CS and confidence in qualified staff in the national referral hospital were also highlighted. Both women and KIs expressed needs for adequate pre-operative care, financial resources, adequate pain control and quality time for interaction with health care providers to improve care after EmCS.
Following EmCS, women have both positive and negative experiences at individual, relationship and health care levels. Positive experiences include successful surgery, presence of a companion and being managed in a national referral hospital. Negative experiences, however, included fear of death for mother and baby, poor pain control, poor communication and informal hospital charges. Financial support, companionship after CS and information on indications for surgery and other interventions were the support needs expressed by the women.
全球范围内，剖宫产率估计为21.1%，是1990年7%的三倍，预计到2030年将达到28.5%。在乌干达坎帕拉的卡韦姆佩国家转诊医院（KNRH），2022年43.0%的女性通过剖宫产分娩，其中95%的手术为急诊剖宫产（EmCS）。然而，尽管了解剖宫产与阴道分娩（VB）相比存在的挑战，但并未探究剖宫产术后女性的经历和支持需求。
探究卡韦姆佩国家转诊医院急诊剖宫产术后女性的经历和支持需求。
在KNRH的产后诊所，对急诊剖宫产术后六周的女性以及作为关键信息提供者（KIs）的医护人员进行了现象学调查。对剖宫产术后的女性进行了深入的录音访谈，并对关键信息提供者进行了访谈。音频记录逐字转录，并使用演绎法，但主要是归纳性的主题技术进行分析。
2023年6月至7月期间进行了20次深入访谈和6次关键信息提供者访谈。女性的平均年龄为27.95岁。大多数女性强调了负面经历，如手术期间担心失去生命、疼痛控制不佳以及医院护理不尽人意，如干预延迟、沟通不畅、歧视和忽视感以及医院的非正式收费。相反，也强调了成功的手术挽救了她们和婴儿的生命、剖宫产后有陪伴者以及对国家转诊医院合格工作人员的信心。女性和关键信息提供者都表示需要充分的术前护理、资金资源、充分的疼痛控制以及与医护人员互动的优质时间，以改善急诊剖宫产后的护理。
急诊剖宫产后，女性在个人、人际关系和医疗保健层面既有积极经历，也有消极经历。积极经历包括手术成功、有陪伴者以及在国家转诊医院接受治疗。然而，消极经历包括母婴对死亡的恐惧、疼痛控制不佳、沟通不畅以及医院的非正式收费。女性表达的支持需求包括经济支持、剖宫产后的陪伴以及关于手术指征和其他干预措施的信息。
