Saving women's lives by spacing births: A qualitative study

Abstract

The purpose of this descriptive ethnographic study was to explore the perceptions about, and the various factors that influence birth spacing decisions by rural Filipino husbands and wives. Short birth intervals of less than two years are a high risk factor for women in the Philippines. Attempts have been made to improve the women's health status and rights in various aspects however, a large number of women in developing countries such as the Philippines, still suffer to a great extent in regard to their health and reproductive health conditions. Fourteen Filipino husbands and wives participated in in-depth interviews over a six month period in rural Philippines. The Household Production of Health nested within the Ecological Model were the conceptual models that guided this research. Data analysis was directed towards identifying themes and sub-themes organized into categories and sub categories answered the four research questions. Eleven domains were identified from the data. Two major cultural themes emerged from the ethnographic data: (1) "Because life today is so difficult, it is important to space births"; and (2) "She's my wife...of course, I have to take care of her, we have to take care of each other." The participants integrated birth spacing and the internal and external factors influencing decision making into a complex process. The participants described their roles in maintaining and promoting health. In addition to their roles in health maintenance, participants also identified a variety of health producing and help seeking behaviors that were contextualized throughout their cultural lives and were consistent with their perceptions. This research has significance for nursing in four aspects: (a) it explicates the importance of having a broader and deeper understanding of how birth spacing and maternal health are perceived by people of different cultural background; (b) it provides a framework for community health nurses and transcultural nurses to analyze the entirety of birth spacing decision processes that do not only occur within the household but within the community and the whole country; (c) it suggests the importance of focusing health education of women's reproductive health such as spacing pregnancies; and (d) it encourages nurses around the world to empower men and women to create change in health policy regarding family planning.