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Birthing support and breastfeeding initiation in Somaliland: Experiences at the Edna Adan Maternity Hospital in Hargeisa, Somaliland

K Holder


Background: Research has identified a relationship between birthing  practices and breastfeeding initiation Continuous support during labor and delivery is a key component to increasing breastfeeding initiation.

Objective: The purpose of this project was to assess the impact of labor support on breastfeeding initiation in a setting in which women receive traditional birthing support from female family members.

Methods: Research was conducted at the Edna Adan Maternity Hospital in Hargeisa, Somaliland using the grounded theory method of qualitative research. Semi-structured interviews, direct observations and participant observations were conducted. A purposeful, non-statistical sample was chosen: ten women, five family members, six health care providers and five birth observations were included. The CDC EZ-Text, a software program developed by the Center for Disease Control and Prevention for use in qualitative research, was used in managing and analyzing the data. Data analysis and interpretation was conducted using micro-analysis, open,
axial and selective coding procedures.

Results: The results indicated that due to cultural influences, contradictory beliefs and practices, lack of critical thinking and lack of long term  planning, traditional birthing support was not always indicative of  immediate breastfeeding initiation.

Conclusions: The presence of a labor companion is a low-cost, preventative intervention that is consistent with the cultural practices of Somaliland. Breastfeeding education and support should, therefore, include a tertiary approach which includes pregnant and birthing women, labor support persons or family members and health care providers.

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eISSN: 0856-8960