Zambian Midwives’ Experiences of Adolescent Pregnancy and Childbirth in a Clinical Midwife Context: An ethnographic study

Abstract

Background:  Adolescent pregnancy is a global health care concern. Approximately one million adolescents, younger than 15 years and 17 million adolescents in the age from 15 to 19 give birth every year, globally. For many Zambian adolescents pregnancy is not the result of a deliberate and conscious choice. Poverty, rural setting, and low education levels predispose many to adolescent pregnancies,
childbirth and school drop-out. This exposes the adolescents to severe outcomes. Young adolescents’ do not have the cognitive capacity or accountability to make life changing decisions. The objective of this study was to investigate and deepen the understanding of Zambian midwives’ experiences regarding adolescent pregnancy and childbirth in a clinical midwife context.
Materials and Methods: The study took an ethnographic interpretative design. Inductive data was collected by observational participation, conversational observations, written field notes and diaries along with interviews with seven Zambian midwives from
January 2015 to March 2017.
Results: The following themes emerged from the ethnographical analysis through  empirical data material with midwives in a clinical midwifery context: (a) the midwives’ attitudes over the adolescent pregnant woman; b) the midwives’ perceived position; (c) the impact of the clinical midwife community culture.
Conclusion: Age, culture and society affects adolescent pregnancy and childbirth. Pregnant adolescents need professional support, access to information and a caring relationship in clinical midwife practice. It is essential that adolescents’ and midwives’ feel that they are all part of the same mission.

Keywords: Adolescents, Childbirth, Ethnography, Midwife, Pregnancy, Zambia