MEN AND LOSS: Exploring Malawian Men's Experience during Obstetric Emergency and Loss; an effort to improve male participation in maternity care

Abstract

Background: Male involvement appears not to be improving in Malawi and researchers attribute this sluggish male participation to culture and patriarchy that inadvertently reproduce inequalities among men and women. Using hegemonic masculinity and socio construction theories as lens, this study explored men's perceptions regarding care given to their wives during emergency obstetric and new-born complications and loss. The study would help inform service providers the hindrances and facilitators of male participation. The study is secondary analysis of qualitative data collected from men in Malawi about loss in child bearing. Seven interviews with men whose wives or very close relative e.g. daughter experienced emergency obstetric or new-born complication and/or loss were analysed. Eleven focus group discussions (FGD) with men and women were also analysed to supplement interview data. Data was analysed manually through thematic analysis and categorised into four themes as follows: knowledge of emergency complications, perceived causes and possible prevention of loss; men's care seeking behaviour and its limitations; men's perception of support received; men's perceptions about the health system Findings: men's knowledge of complications was based on what they had been told by either wives themselves or female guardians. Men admitted that they did not know what happened to their wives and babies because they were not there and expressed wish to be there during childbirth. The health system contributed to men's frustration of care given to their wives through lack of resources like blood, ambulance and poor quality of supervision of service providers. Men did not get much support from service providers during emergency complication and loss and most men were supported by relatives. Service providers failed to use men's presence as an opportunity to involve men in maternity care as they isolated men from the actual care provided to their wives and let men stay outside with no regular updates of the progress of their wives. Conclusion: men's failure to participate in maternity care is not merely because of socio constructions and masculine ideals that do not allow men to participate in issues categorised as feminine; but because the health system fail to motivate the few men that seek care together with their wives. Treating women in isolation from those that have been taking care of them since onset of pregnancy can be frustrating to men more especially in time of complication or loss.