Assessing maternal satisfaction after caesarean section in government hospitals in Durban, KwaZulu-Natal: A qualitative study

Abstract

Background: Maternal satisfaction after a caesarean section (CS) is a key quality indicator, yet understudied in low-income and middle-income countries. This study used a qualitative method approach to address that gap, by exploring factors influencing maternal satisfaction in South African government hospitals, focusing on pain management, emotional support and communication, within the local context of KwaZulu-Natal.
Methods: A qualitative descriptive study design was employed. Women who underwent CS in two government hospitals in Durban were included in the study. Data were collected using questionnaires for socio-demographic information and semi-structured interviews. Thematic analysis was used to identify and code themes related to maternal satisfaction.
Results: A total of 100 women were interviewed. Three-quarters of the women (n = 77) were satisfied with their CS experience, with only one participant expressing dissatisfaction. Maternal satisfaction was likely primarily related to positive delivery outcomes. Factors that improved satisfaction included effective pain management, a supportive ward atmosphere, and interactions with peers. Despite overall positive responses, only one-third were willing to undergo CS in the future. Maternal satisfaction was reduced by issues like insufficient preoperative information, language barriers, limited autonomy, and a lack of breastfeeding or emotional support.
Conclusion: Most women reported satisfaction with their CS experience, yet expressed reluctance to undergo the procedure again. This paradoxical phenomenon highlights the complexity and multifaceted nature of maternal satisfaction. Healthcare providers should prioritise open communication, empathy, and respect for women’s preferences and values to provide high-quality, patient-centred care.
Contribution: The study highlighted the need for responsive, equitable, and person-centred approaches to CS care, particularly within resource-constrained public health settings. By addressing the identified gaps and implementing targeted, theory-informed strategies, healthcare providers and policymakers can take meaningful steps towards improving maternal experiences and outcomes across South Africa’s government hospitals.