Navigating the Perils of Pregnancy and Childbirth Among Youth in La Pointe, Haiti: Insights Captured Through Community Photovoice Research.

In Haiti, surviving pregnancy and childbirth is especially tenuous for young women, who are already marginalized. One of the four leading causes of death for women 20-24 years old is pregnancy- or childbirth-related. An important gap remains regarding youth perspectives of maternal health and well-being within their communities. We conducted a community-based participatory research study using Photovoice to understand the lived experiences of 17 young women from La Pointe, Haiti, and its surrounding rural communities, who survived a maternal near-miss, a grave obstetric event that one narrowly escapes. Youth participants took photographs and participated in individual interviews and focus groups to represent and share their pregnancy and birthing experiences. Visual and narrative data were analyzed by participants and our community research team using reflexive thematic analysis. The five main themes represent a perilous maternal journey. The themes included (a) the social context youth are embedded within, (b) structural, systemic and political forces youth face, (c) pain and suffering throughout youth maternal experiences, (d) search for support during the maternal trajectory, and (e) youth-generated solutions for improved maternal health and well-being. Our findings amplify youth voices on the pressing need to address multiple, intersecting issues that shape maternal health and well-being for all women with particular attention to the needs of young women. Understanding the experiences of Haitian youth survivors of maternal near-misses can inform research, practice, and policy to curb maternal deaths and maternal near-misses among young women within low-resource settings.