Women’s experiences of communication with medical staff before and after emergency caesarean birth in Zambia: A qualitative study

Abstract

BACKGROUND: Communication between patients and staff during emergency caesarean birth is important for ensuring positive outcomes and reducing the negative psychological impact of the procedure. Communication failures have been linked to obstetric violence, mistrust, and post-traumatic stress disorder. This study aimed to explore patient-healthcare provider communication before and after emergency caesarean birth at the University Teaching Hospitals, Women and Newborn Hospital in Lusaka, Zambia. METHODS: This study employed a qualitative phenomenological design to explore the lived experiences of women who had undergone emergency caesarean birth. Interviews were conducted with 30 women who were purposively sampled from the hospital's wards. An inductive thematic analysis, which involved transcribing interviews, reading and rereading transcripts, coding, categorising similar codes and developing themes, was used for data analysis. RESULTS: Thematic analysis yielded four primary themes: mode of communication, emergency caesarean birth communication experience, consequences of inadequate communication and information, and barriers to effective communication. Communication between healthcare providers and women who underwent emergency caesarean birth was inadequate, untimely and lacked detail about the surgical procedure. As a result, women felt afraid, angry, and anxious, resulting in a sense of worthlessness and helplessness. The use of medical jargon by healthcare providers, misconceptions about caesarean birth, the presence of pain and poor staff attitudes towards mothers were identified as some of the communication barriers. CONCLUSION: The findings highlight systemic gaps in provider-patient communication during emergency caesarean birth, influenced by workload pressures, staff shortages and power dynamics. Interventions are needed to promote respectful maternity care through training in patient centred communication, use of simple language, and addressing structural barriers at the University Teaching Hospitals Women and Newborn Hospital. Clear communication can help to improve the overall experience of caesarean birth.