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The role and status of women in South Asian countries like Nepal are widely recognised to be lower than that of men. This gender inequality can be found throughout all levels of society. Our study is about the influence of gender on pregnancy and childbirth, which are very much in the female domain in South Asia, both at home and in health facilities.
A mixed-method, qualitative research study was undertaken in two birthing facilities in Kathmandu Valley to examine barriers to women accessing these services from the perspective of hospital staff. Thematic analysis identified seven subthemes related to gender, namely: (1) support from family, autonomy & decision making; (2) women’s workload; (3) finances; (4) women wanting female doctor; (5) consent; (6) delivery room; and (7) preference for male offspring. Overall, gender-based roles negatively impacted many stages of the mother’s childbirth journey. Some staff recognised gender roles as a barrier to women accessing services but did not recognize themselves or their practices as a potential barrier.
Gender issues identified at both birthing facilities generally reflect those of Nepali society as a whole. Raising awareness among maternity-care workers about gender issues and what they can do about it in personal interaction and how they reflect can on it would be the first step to improving the experiences of women of childbearing age.