WOMEN’S PERCEPTIONS OF MIDWIFERY IN SAUDI ARABIA: FACILITATORS AND BARRIERS TO SEEKING AND RECEIVING CARE

Abstract

Keywords: Midwifery care, women’s perceptions, maternal healthcare, natural childbirth, barriers and facilitators, continuity of care, medical interventions, maternal education, woman-centered care, regional disparities.

Midwifery is recognized as a powerful tool in normalizing the birthing process. It provides continuity of care through pregnancy, birth, and the postpartum period, and reduces the use of medical interventions during the natural process of childbirth. This dissertation examined perceptions of midwifery care and facilitators of and barriers to seeking midwifery services among childbearing women in Saudi Arabia. Aim 1 explored Saudi women's perceptions of midwifery care. Aim 2 assessed the factors that facilitated or hindered Saudi women’s ability to access midwifery care in Saudi Arabia. Using interpretive description methodology, these aims were accomplished through semi-structured interviews with 30 Saudi women of childbearing age (18-49 years) across five regions in Saudi Arabia. Data were analyzed with Braun and Clarke’s thematic analysis. Findings from Aim 1 revealed that Saudi women have positive perceptions of midwifery care. Participants expressed appreciation for midwives' holistic and woman-centered approaches to care that emphasized natural birth practices and provided physical and psychological support and comprehensive maternal education. Findings from Aim 2 showed that several facilitators encouraged Saudi women to seek midwifery care, including women’s preferences for natural childbirth practices encouraged by midwives, psychological support, maternal education, trust in midwives’ expertise, and positive personal and shared experiences with midwives. In addition, Aim 2 findings revealed several barriers to Saudi women seeking midwifery care, including lack of community awareness, limited access to midwifery services, lack of trust in midwives’ competencies, and negative perceptions and past experiences with midwives. Region-specific differences were also apparent, with women from western and central regions of Saudi Arabia reporting more positive perceptions of midwifery than women from northern, southern, and eastern regions who faced extensive barriers to midwifery care. The findings of this study are a benchmark to enhance midwifery care by increasing public awareness about midwifery, strengthening midwifery training, increasing workforce capacity, and expanding its services across Saudi Arabia, all of which can enhance maternal outcomes and encourage women to seek holistic, woman-centered maternity care.