Negative Birth Experiences (NBEs) in the Netherlands: A qualitative content analysis on the driving factors of NBEs from the #breakthesilence social media campaign

Abstract

Introduction: Recently there has been increasing awareness on negative birth experiences (NBEs) that occur among women in the Netherlands. The Dutch social media campaign, #genoeggezwegen (#breakthesilence), shared the stories of these women who endured such negative and traumatic birth experiences. This study aimed to identify the driving factors of NBEs in the Netherlands by analysing the stories shared by the #GG campaign, in order to better understand why NBEs occur in the first place. Methods: A qualitative content analysis study was conducted using an existing dataset of #GG stories collected from the 2016 campaign and produced by van der Pijl et al (2020). Stories were analysed through a deductive and inductive coding procedure using Bohren et al’s work on the mistreatment of women during birth and the WHO framework on improving maternal care. Results: 416 stories were included for analysis. Themes that were identified were: health system conditions and constraints; power dynamics between the care provider and client; poor communication; lack of professionalism; culture surrounding natural childbirth; lack of emotional support; discrimination; and misinterpretation of interaction between the care provider and the client. Managing expectations was identified as an overarching theme. Conclusion: This study demonstrates how several factors can interplay and influence a woman’s experience of birth. Such factors can be at the interpersonal level, in which clients may need to manage expectations better and care providers provide better care. These determinants, however, are accompanied by and may also be influenced by systemic/institutional level factors, implying that there are changes to be made at a structural level to prevent NBEs.