Give Birth to a Female Child: A Qualitative Study Exploring Mothers' Experiences of Multiple Female Childbirths in Jordan

Background

Childbirth experiences were distinctive, provoked exceptional feelings, reactions, and challenges to postpartum women. Gender reveal parties are popular in the U.S, nearly half of Americans appeal to wait birth to detect their child is a boy or girl, as expecting parents excitedly with others their unborn child's sex [1]. The most common method used to reveal fetal sex in the 2nd and 3rd trimesters accurate in greater than 99% of cases are ultrasound [2]. By the beginning- 1990s, sex selection has a long history was initially observed post- birth by the act of killing unwanted sex/gender of the children: The female one, without exclusion could be progressively pursued through abortion [3]. A woman's life undergoes biological, psychological, and social change throughout childbirth.

These modifications can aid in individual development and satisfaction, but they may also put postpartum women at risk for emotional distress. These aspects relate to specific cultural patterns and include birth of a daughter when a son was required [4]. Gender is a major social determinant. In some communities’ female gender is socially and culturally shaped by roles and responsibilities. Childbirth may be positive experienced in many ways [5].

Educated women from urban backgrounds without the old mindset believed that ‘men are higher and superior to women’, educated women believed that they can be capable to accept the baby gender than man. Major difficulties facing maternal mothers, such as age of maternal, complications during pregnancy, difficulty in conceiving, were the anticipations for the child's gender conflicts [6].

The gender of new baby birth for many parents an exciting occurrence, or can be anxiety or nervousness event, maternity mother feels of guilty, and uttering negative feelings about female childbirth rearing, also feel that is a stigma of failure attached to expression displeasure in the female motherhood experience, when a parent’s strong wanted a certain sex is not realized [7]. Furthermore, previous studies regarding child gender influence offer insights into certain challenges effect on mothers, gender indicates to “all duties, rights, and behaviors a culture considers appropriate for males and females” [8]. Childbirth can be defined as “experienced elicited unique feelings for responses interpretations, and challenges to mothers during birth processes” [4].

Recognizing the women’s childbirth experiences and they identify indicating is an important issue, some mothers meant exciting and lovely event however others meant it is a worrying and consuming. Negative experiences outcomes have been associated with poor support and care, excessive fear of childbirth pain, and discomfort during delivery [9].

Methodology

Phenomenology was the philosophical and methodological framework chosen for the study. Husserl’s specific philosophy of phenomenology, Husserl’s descriptive phenomenological methodology, and Colaizzi’s (1978) method of phenomenological data analysis used. A phenomenology is remarkably useful when a phenomenon has been inadequately defined. The topics appropriate to phenomenology are ones that are fundamental to the life experiences of humans; for health researchers, these include such topics as the meaning of suffering, the experience of domestic violence, and the quality of life with chronic pain. The goal of phenomenological inquiry is to understand fully lived experience, insist on the careful portrayal of ordinary conscious experiences of everyday life a depiction of “things” as people experience them [10].

Descriptive phenomenological approach as a research method in the current study to explore the lived experiences of Jordanian mothers who give birth to a female daughter and had many females in the family. Sampling, the target population for this study is Jordanian mothers who have multiple female childbirth. A convenience, purposive sampling method was chosen to enable deepen understanding of whatever phenomenon, the study included mothers who had multiple experience with female birth. In the current study the sample size between 10-12 participants. Study Setting, study conducted in one governmental teaching hospital in Jordan, which is the first teaching university hospital in the Hashemite Kingdom of Jordan, and one of the first hospitals in medical education at the Arab level.

Ethical Consideration

Institutional Review Board from Jordan University will be obtaining for this proposal. The official agreement letters to conduct study in the designated setting sent, each participant was asked to sign an informed consent. Each participant gives detailed information about the study (verbal and written). The researcher was making sure that the participants understood the information, ensuring that the participation was voluntary. The participants were informed that the interviews were recorded on a digital recorder.

Data Collection Procedure

To investigate and interpret the meaning of “lived experiences”, descriptive phenomenology involves bracketing suspension of all suppositions to isolate an individual’s true lived experience which stopped when the research stopped (Creswell& Poth, 2017). The researcher tended to investigate certain pieces of information by probing into a semi structured; face-to-face interview format [11]. All the interviews started with the researcher who introduced herself and explained the purpose of the study, the participant’s rights, and the method through which the data was collected. Then the researcher confirms the participants’ agreement to record the interviews. Meeting mothers conducted in a private room at the hospital, for mothers ‘sense of intimacy and security. When no new themes or data emerged following data analysis in the current study, the researcher stopped collecting data and conducting interviews.

Data Analysis Procedure

The processes leading to data analysis were data collection, coding, followed by the data analysis. Qualitative research approach encourages flexibility which is important [10]. Data analysis using Colaizzi’s (1978) method for qualitative approach that ensures the credibility and reliability for results. It enables researchers to identify emerging themes and the connections between them. This approach allows for the exploration of the essential structure of an experience in a straightforward and logical manner [12].

Results

According to analysis of one story describing postpartum mother the result demonstrated that are two themes. The first theme: Challenges faced by woman regarding psych-emotional health, and the second theme: lack of family and spousal coping methods that described the essence of mother experience for multiple female childbirth. The findings from the interview have emerged as themes broken into sub-themes and codes. The first theme: Challenges faced by woman regarding psych-emotional health provided by family members incorporated the approaches of spousal and family relationships that were provided to the woman during pregnancy, at the time of delivery, and the post-partum period. Order to demonstrate, it includes caring, emotional, financial, and family support provided at the pregnancy, during delivery, at discharge to home, and cultural support provided to postpartum woman. For example, Mother shared the perspectives about childbirth experiences at first, second and third time, which had different shaped, described her dreams about first baby and recalled that the first time she saw her daughter was very emotional.

A first-time mother. Ten mothers explained: “I was happiness after the birth of my daughter: When she came out, I felt very, happy because it’s a beautiful girl… “and all around my happy”. At second pregnancy Mother reported that her husband doesn’t care for second female childbirth. “She said that she is feeling frustration and husband no longer being given respect for her…”. “caused more stress….”. At third pregnancy five mother explains that: having the hardest time because they know that they have female at pregnancy, mother described changed her sleep pattern, they feel of anxiety and fear from husband, and mother had depression because they wished to die after delivery “they said that I can’t sleep or eat… “I feel of anxiety to identify gender of baby…”. line and I Fear from husband” line 48 “I wish to be died”.

Mothers understands that her husband, family does not want her to have a female kid. they described her husband’s aggressive and anxious response. “said my husband didn’t assist me when he knew the baby’s gender”. Emotional distress, the seven mothers claim that they felt uncomfortable and that her marriage’s stability is still under danger. “said I am afraid that he will marry and leave me and the girls.” The second theme lack of family and spousal coping methods describes the challenges that could be considered obstacles for woman unsatisfaction with spousal relationship and spousal coping methods, according to the mother perception. they explain that: “my husband doesn't support me when hear that the gender of baby is female and screaming…,” “he was not supportive me……”. husband's behavior is unacceptable……,”. “and he embarrassed her…”.

Furthermore, challenges interfering with the role of the husband in giving proper support appears as financial and violates the privacy of women during pregnancy and postpartum period, four women explain that: “my husband leave me alone in clinic without any cash money……”. “when l discharge from hospital, I didn’t find any things in fridge to eating, my father brought all things……” seven women explain that spousal isolation expressed that “my husband goes to another room and sleeping”. Spousal punishing actions the mother expressed that “my husband screaming when he heard that I gave birth for female twins and insulting the Divine, also he doesn’t support my, or visited me at hospital, or call me”

Conclusion

This study has begun to explore experiences of Jordanian women who have multiple female childbirth in Jordan, and the challenges they face. This phenomenology study aim to understand fully mother lived experiences. This study result demonstrated that mother suffering a bitterness of quality of life for multiple female childbirth, experience of domestic violence, spousal isolation, aggressive spousal reaction for female gender, and emotional hazard after female childbirth, such as Sorrow/ Grief feeling, destroy mother dreams and hopes, and conflict and stress inside her spousal family. According to this study, mother is given the chance to describe her experiences of motherhood, as well as her relationships with her family, woman also described the obstacles she has troubles with husband to have multiple female childbirth, women identified several factors that influenced the changes that occurred in their marital relationship. The important point the continuity of marital relationship is threatened because of the multiple birth of the females [13-22].

References

1. Sivanand. (2019). HHS Public Access.Physiology & Behavior, 176(3), 139–148.
2. Beyers-Carlson, E., Schoenebeck, S., & Volling, B. L. (2022). Mother of one to mother of two: a textual analysis of second-time mothers’ posts on the BabyCenter LLCWebsite. Frontiers in Psychology, 13, 859085.
3. Before, E., Before O., & Of, I. (n.d.). Sdl (s. 47–62.
4. Mohammad, K. I., Gamble, J., & Creedy, D. K. (2011). Prevalence and factors associated with the development of antenatal and postnatal depression among Jordanian women. Midwifery, 27(6), e238-e245.
5. Holopainen, A., Verhage, M. L., & Oosterman, M. (2020). Childbirth experience associated with maternal and paternal stress during the first year, but not child attachment. Frontiers in psychiatry, 11, 562394.
6. Guo, X. D., Gao, F., Jia, Y. N., & Wang, A. H. (2020). Birthexperiences of urban women of advanced age having their second child after introduction of the universal two-child policy in China: A qualitative study. Midwifery, 91, 102853.
7. Hendl, T., & Browne, T. K. (2020). Is ‘gender disappointment’a unique mental illness?. Medicine, Health Care and Philosophy, 23(2), 281-294.
8. Alzoubi, F. A. (2011). Motherhood and Childbirth Experiences among Newcomer Women in Canada: A Critical Ethnographic Study.
9. Namujju, J., Muhindo, R., Mselle, L. T., Waiswa, P., Nankumbi, J., & Muwanguzi, P. (2018). Childbirth experiences and their derived meaning: a qualitative study among postnatal mothers in Mbale regional referral hospital, Uganda. Reproductive health, 15, 1-11.
10. Polit, D. F., & Beck, C. T. (2016). Essentials of nursing research: Appraising evidence for nursing practice (8th ed.). Philadelphia: Lippincott Williams & Wilkins.
11. Ritchie, J., Lewis, J., Nicholls, C. M., Ormston, R. (2013). Qualitative Research Practice: A guide for Social Science Students and Researchers (2nd ed.). Los Ageles. London. New Delhi. Singapore: Sage.
12. Wirihana, L., Welch, A., Williamson, M., Christensen, M., Bakon, S., & Craft, J. (2018). Using Colaizzi’s method of data analysis to explore the experiences of nurse academics teaching on satellite campuses. Nurse Researcher (2014+), 25(4), 30.
13. Ahmed, G. K., Elbeh, K., Shams, R. M., Malek, M. A. A., & Ibrahim, A. K. (2021). Prevalence and predictors of postpartum depression in Upper Egypt: A multicenter primary health care study. Journal of Affective Disorders, 290, 211-218.
14. Council, S., Entity, U. N., Equality, G., & Women, U. N. (2022). General Framework for Gender Equality in Jordan.
15. Essaid, A., Sajdi, J., & Taleb, H. A. (2019). GenderDiscrimination in Jordan. 1–34. www.irckhf.org.
16. Maabreh, R. (2019). Postpartum Depression Experience Among Jordanian Mother With Hospitalized Infant in Neonatal Intensive Care Unit: Incidence and Associated Factors. Global Journal of Health Science, 11(5), 1-21.
17. Ye, Z., Wang, L., Yang, T., Chen, L. Z., Wang, T., Chen, L.,... & Qin, J. (2022). Gender of infant and risk of postpartum depression: a meta-analysis based on cohort and case-control studies. The Journal of Maternal-Fetal & Neonatal Medicine, 35(13), 2581-2590.
18. Paudel, M., Javanparast, S., Dasvarma, G., & Newman, L. (2018). A qualitative study about the gendered experiences of motherhood and perinatal mortality in mountain villages of Nepal: implications for improving perinatal survival.BMC pregnancy and childbirth, 18, 1-18.
19. Pinar, C. (2020). Book Review: Gender before Birth: Sex Selection in a Transnational Context by Rajani Bhatia.
20. Jordan University Hospital. (2023) Retrieved from
21. Bevan, M. T. (2014). A method of phenomenological interviewing. Qualitative health research, 24(1), 136-144.
22. Patton, M. Q. (2015). Qualitative research & evaluation methods (4th ed.). Thousand Oaks, CA: Sage Publications.