Women’s experiences of high-risk pregnancy care in resource constrained Cape Town communities
| dc.contributor.author | Cebekhulu Gugulethu | |
| dc.contributor.author | Andipatin Michelle G | |
| dc.date.accessioned | 2025-11-11T07:35:41Z | |
| dc.date.available | 2025-11-11T07:35:41Z | |
| dc.date.issued | 2025 | |
| dc.description.abstract | A high-risk pregnancy elicits inherent fear for women, which has an impact that is great and far-reaching, often resulting in psychological health challenges both during and after pregnancy (minnaar 2020). Pregnancy is classified as high-risk when there is a possibility of difficulties during pregnancy, birth or the postpartum period, for either the mother or the growing baby (soh & nelson-piercy 2015). In low- and middle-income countries (lmics), where 99% of all maternal fatalities take place, women are more vulnerable to experiencing severe morbidity and mortality during pregnancy, delivery and the postpartum period (heitkamp et al. 2021). It is widely known that healthcare institutions in lmics generally face considerable limitations (meghji et al. 2021). Therefore, socioeconomic factors that are highly linked to morbidity and mortality have had a significant influence on the health of the majority of south africans (militao et al. 2022). Individuals in impoverished regions face systemic limitations that influence their behaviour (vilar- compte et al. 2021). For example, they are more likely to consume unhealthy food because of the limited access to nutritious grocery shopping options beyond convenience stores, liquor stores and fast-food establishments, which primarily serve high-fat, high-sugar and high-salt items (vilar- compte et al. 2021). These unhealthy alternatives may often lead to many women being at risk for major health issues, including obesity, hypertension and gestational diabetes, which might endanger both their lives and the lives of their unborn children (langley-evans 2022). Consequently, despite the south african government’s efforts to enhance care for expectant mothers and children, disparities in perinatal and maternal outcomes predominate and continue (ngene, khaliq & moodley 2023). Although south africa’s health system was formerly segregated based on race, it continues to reflect the social divisions of the nation (maphumulo & bhengu 2019). For example, there are currently two healthcare systems – the public healthcare system which serves the poor majority and the private healthcare system which caters to those who occupy the higher socioeconomic status. Despite south african citizens being able to access free healthcare through the public healthcare system, a major drawback is that it is grossly underfunded despite servicing a large percentage (84%) of the population (maphumulo & bhengu 2019; mhlanga & garidzirai 2020). This challenge often manifests as long waiting periods for patients and a highly stressful working environment for healthcare professionals (crush & tawodzera 2014; wium, vannevel & bothma 2019). In addition, south africa’s healthcare system is underpinned by the biomedical model, which views the human body as a mechanical, universal object that is devoid of culture (pentecost et al. 2018). According to this line of thinking, pregnancy is viewed as purely physical, which undercuts the significance that culture and experience have on pregnant women’s interpretation of their experiences (nuño de la rosa, pavličev & etxeberria 2021). Thus, interactions with clinical professionals often do not provide women with the necessary emotional and psychological fulfilment that they require. Furthermore, african traditions and beliefs, which promote wholeness, a treatment approach that considers the full individual, including their social environment, stand in sharp contrast to the biomedical model (holst 2020). As a result, this system challenges south african society’s conventional, moral, and spiritual values. Moreover, according to the biological model paradigm, a pregnant woman is automatically at health risk, categorised as either ‘high–risk’ or ‘low–risk’ (majella et al. 2019). As a result, pregnancy has taken on a techno-medical aspect as medical experts approached it like a disease rather than something that is normal and natural (majella et al. 2019). Pregnant women are classified as ‘high-risk’ based on statistics rather than personal factors (van teijlingen et al. 2005). This has given rise to the claim that giving birth is only safe in a hospital with medical staff present (yuill et al. 2020). Thus, a ‘high-risk’ label subsequently leads to intense monitoring and frequent interaction with healthcare providers (heemelaar et al. 2020). The ‘high-risk’ classification is an extremely stressful event that is intrinsically terrifying for women (minnaar 2020), making it crucial for healthcare providers to show compassion. However, the biomedical framework uses technical language which often leaves patients feeling left out as they are unable to comprehend their own diagnosis (khan 2019). There are very few studies that have looked at women’s subjective experiences after a high-risk pregnancy in the setting of south africa. Despite it being well recognised that pregnancy affects a woman’s overall state of health and emotional well-being (abrar et al. 2020; cole-lewis et al. 2014), pregnancy is still viewed as a techno-medical event as researchers persist in concentrating on the physical conditions, ignoring the psychological distress that mothers face (nagar et al. 2015; torabi et al. 2012). Women from developing countries are more exposed to stress and risk factors such as socioeconomic deprivation and poverty, increasing the likelihood for developing mental health problems (nielsen-scott et al. 2022). Given that one in five women residing in lmics experience a mental disorder during and after pregnancy (mitchell et al. 2023), it is unclear how south african women diagnosed with high-risk pregnancies interact with the healthcare system. Thus, the purpose of this study is to address this gap by investigating how a sample of women from resource-deprived neighbourhoods diagnosed with a high-risk pregnancy experienced the south african public healthcare system | |
| dc.identifier.citation | Cebekhulu, G. & Andipatin, M.G., 2025, ‘Women’s experiences of high-risk pregnancy care in resource constrained Cape Town communities’, Health SA Gesondheid 30(0), a2890. | |
| dc.identifier.uri | https://doi.org/10.4102/hsag.v30i0.2890 | |
| dc.identifier.uri | https://hdl.handle.net/10566/21398 | |
| dc.language.iso | en | |
| dc.publisher | AOSIS (Pty) Ltd | |
| dc.subject | high-risk pregnancy | |
| dc.subject | government healthcare services | |
| dc.subject | subjective experiences | |
| dc.subject | resource-constrained | |
| dc.subject | Western Cape | |
| dc.title | Women’s experiences of high-risk pregnancy care in resource constrained Cape Town communities | |
| dc.type | Article |
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