Author: Sabitra Kaphle
Kaphle, Sabitra, 2012 Uncovering the Covered: Pregnancy and Childbirth Experiences of Women Living in Remote Mountain Areas of Nepal, Flinders University, School of Medicine
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The ongoing effort to reduce maternal and neonatal mortality in developing countries has not been able to achieve the expected level of success. Although there has been progress in increasing access to medical care during pregnancy and childbirth in many countries, the associated mortality in most developing countries remains high. The Western medical model has often failed to consider the socio-cultural dimensions of women living in diverse cultural settings. The maternal and neonatal mortality rate in Nepal is still a serious public health issue. Although the maternal mortality rate of the country is declining, the neonatal mortality rate is still significantly high. The maternal and neonatal health situation in the mountain areas of the country is even worse, where the majority of births take place at home without professional assistance. This qualitative study draws on local voices in order to understand the factors which have an impact on women's experiences of pregnancy and childbirth in remote mountainous Nepal. This study uses social constructionism and critical feminism to gain an in-depth understanding of the pregnancy and childbirth experiences of women. Fieldwork was conducted in a remote mountain district of Nepal with in-depth interviews being undertaken with pregnant and postnatal women, family members, service providers and local stakeholders in the two remote mountain villages. Data were analysed using an inductive thematic approach of qualitative data analysis from which three key themes emerged: the tradition and culture of childbirth; women, their relationships and childbirth experiences and the complexity of the context of the women. It was revealed in the study that the childbirth experiences of women are a collective socio-cultural construct which happens in a complex socio-cultural setting. A complex interaction of socio-cultural factors was found to be influential in shaping women's pregnancy and childbirth experiences which impacted their safety. The contribution of both socio-cultural and medical paradigms is therefore argued for to enhance safety during the pregnancy and childbirth experiences of women living in the remote mountain villages of Nepal. This needs consideration at both policy and practice level.
Keywords: socio-cultural,childbirth,power influences,gender,birth pollution,tradition,rural/remote,dialogue
Subject: Public Health thesis, Medicine thesis
Thesis type: Doctor of Philosophy
School: School of Medicine
Supervisor: Dr Lareen Newman