Introduction and Background

This research presents findings from a qualitative research study that was
conducted with women to ask about their experience of husband support during
pregnancy. It highlights the ways in which the participants in the study talk about
pregnancy, support, complication, and satisfaction in their pregnancy and the
discourses that inform their talk.
In this introductory Chapter the statement of problem, rationale for this study is
explained and an overview of the subject is provided. The Chapter starts off by
presenting the context within which this study was conducted as well as the
background. This is followed by definition of terms that are commonly used in this
research. It then proceeds to explain the rationale and objectives of the study. The
theoretical background used in this study.
1.1 Introduction
The behavior of men, their beliefs and attitudes affect the maternal health
outcomes of women and their babies. The exclusion of men from maternal health
care services could lead to few women seeking maternal health services and as a
result worsening the negative maternal health outcomes for women and children.
Increasingly, recognition is growing on a global scale that involvement of men in
reproductive health policy and service delivery offers both men and women
important benefits (Naomi, 2015).
This slow progress in reducing maternal mortality is as a result of a number of
factors including lack of maternal health services and in some cases where services
exist some husbands have been reported to refuse their wives to seek maternal
health services (Bryanton, 2008).
Globally, low male involvement in maternal health care services remains a
problem to health care providers and policy makers. Since the Cairo international
conference on population and development (ICPD) 1994, and the Beijing world
1
conference for women 1995 a lot of emphasis has been to encourage male
involvement in reproductive health including maternal health. The Beijing
conference emphasized that man’s attitudes, knowledge base and ways of reacting
influences not only men’s health but also women’s reproductive health (WHO,
2016).
At the 1994 ICPD in Cairo the participating (179 nations) nations agreed on
the action plan, which stated that” Changes in both men’s and women’s
knowledge, attitudes, and behavior are necessary conditions for achieving a
harmonious partnership between men and women. This would open doors to
gender equality in all spheres of life, including improving communication between
men and women on issues of sexuality and reproductive health, and improving
understanding of their joint responsibilities. (UNFPA, 2011)
Following that action plan there is a positive trend globally of increasing male
involvement in reproductive health including maternal health services though not
without challenges.
Where health services exist there are many reasons why men do not use
them particularly in relation to reproductive health. Studies done in several
countries globally have reported cultural, social economic, program factors, policy
issues and communication issues as the factors influencing male involvement.
Identifying and overcoming these obstacles requires working with women, young
people and men to understand better their needs analyze their problems and to
propose acceptable solutions (WHO, 2014). Understanding the factors affecting
male involvement in antenatal, delivery and postnatal care services in Jinja district
is important in order for health service managers and health workers to design
interventions that will encourage and maintain male involvement. Increased male
involvement in maternal health care services is likely to improve maternal and
child health outcomes.
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1.2 Background
In our cultures in Palestine, regard maternity care as a female domain, Men
in traditionally not been involved in the maternity care of their partners. They do
not normally accompany their partners to family planning or antenatal care
consultations and are mostly absent during labor and delivery.
However, male dominance socially and in sexual relations can put women at
serious risk of unwanted pregnancy and infection; in pregnancy, male sexual
behavior can affect the health outcomes of both mother and baby. Their lack of
participation at family planning, antenatal and postnatal consultations means that
they do not benefit from any information given by health providers, regarding the
health of mother and baby, or about their role in it . This study, therefore, aimed at
exploring the perceptions of women, towards male involvement in maternal health
care in West Bank, Palestine.
The failure to incorporate men in maternal health promotion, prevention and care
programs by policy makers, program planners and implementers of maternal health
services has had a serious impact on the health of women, and the success of
program (Greene et al, 2012). Yet the huge majority of women are still unaware of
their fundamental rights to health and they continue to suffer from socioeconomic
discrimination and unwanted pregnancies which are harmful to their health (WHO,
2014).
The United nations expert group on women and finance estimated that 70
percent of the world’s population living on less than a dollar a day are women
(Were, 2009) Women tend to have less education and have fewer job
opportunities, this influence their maternal health seeking behavior and maternal
health outcomes. Greater male involvements in maternal health programs may help
reduce un-intended pregnancies and transmissions of sexually transmitted
infections as well as improve child survival.
3
The tendency to view maternal health as a woman’s issue has contributed to a
narrow focus of targeting mostly women. Yet we know that the social relationships
determine people’s ability to manage their sexual and reproductive health (SRH)
lives, with important implications not only to their health but also for other life
choices (Greene et al, 2012).

1.3 Statement of problem and Justification of the study

Worldwide, every pregnancy faces an element of risk, men, as partners and
decision makers, need to be involved in maternal health services, Low male
involvement in maternal health care services results in low utilization of ANC,
health facility delivery and postnatal care leading to high maternal morbidity and
mortality. Men’s accompanying their wives in routine ANC and other maternal
health services is an important factor in contributing to the reduction of maternal
morbidity and mortality. According to Thaddeus and Maine (2011) men can
positively affect the prevention of maternal and child mortality by being able to
recognize an obstetric emergency, take a decision to seek care and being able to
transport the pregnant women to obtain health services. Men accompanying
women for antenatal care presents an opportunity to the health workers to health
educate them and empowering men to be able to recognize an obstetric emergency
early in order to make appropriate decisions and actions that may influence the
outcome of the pregnancy.
This aim study is to contribute to better understanding of the factors that make men
get involved in ANC, delivery and postnatal care. Information generated will be
used to provide decision-making and actions that will lead to increased male
involvement in maternal health care services. Increased male involvement in
maternal health care services will subsequently, lead to increased utilization of

4
maternal health services by the pregnant women, mothers and their children (Story,
et al., 2012).

According to Cooper, (2005) The factors that affect male involvement in

maternal health care services may be categorized into Cultural factors, socio-
economic, health facility factors, inter-spouse communication and perceptions men
have on maternal health services in the district .
Cultural Factors include; Polygamy, this has been associated with family wrangles
that may hinder the man from treating his wives equally. Health facility factors
included; Lack of privacy, comfort and lack of confidentiality, Poor attitude of
health workers adversely affect men’s capacity to be involved in maternal health
services.
Inter spouse communication; absence of inter-spousal communication and
discussion can inhibit male involvement in maternal health care services. This
prevents men from taking appropriate maternal health decisions.
Perceptions men have on maternal health services perceptions that maternal health
care services offered is poor and that services could be very expensive for both
spouses to access. Low male involvement in maternal health care services will lead
to low utilization of these services by the pregnant women, mothers and their
children, which will lead to high maternal and infant morbidity/mortality (Klaus &
Kennell, 2007).

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1.7Aim:
To explore the perceptions of women, towards male involvement in maternal
health care in West Bank, Palestine

Objectives:
1. to exploring the perceptions of women, towards male involvement in
maternal health care
2. To determine the extent of men participation in maternal health care
3. To understand what are the factors thatcontribute to better level of men's
participation in maternal health care

1.4 Research Question:

Main questions is:
 What isperceptions of women, towards male involvement in maternal
health care?
 What is the extent of participation of men in maternal health care?
 Is there a relationship between the men's age and level of educationwith
participationin maternal health care?
 Does increase thenumber of child for men improvetheir participation in
maternal health care?
 What the factor that prevent the men participation in maternal health
care?

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 Conceptual framework Factors affecting male involvement in maternal health
care services
Socio- economic factors Perceptions /Attitudes
Age
Negative Attitude of men and women
Education
Most service providers are women
Financial difficulties
Lack of information
Myths and misconception

Low male involvement in maternal healthLow

carefemale utilization of maternal health services
services

Cultural factors
Poor communication among spouses

Traditional beliefs

Polygamy
Health facility factors
Attitude of health workers
Quality of care
Waiting time
Availability of health workers
Availability of services
Affordable services/cost
Accessibility of services

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CHAPTER Two: Literature Review
Introduction
A systematic search of the literature was performed to obtain original studies that
investigated the role of husbands in support their wives during pregnancy . The
relevant studies were identified by the use of Google Scholar and the PubMed
database. In our primary search, used with the following key words: first, Husband
support AND (pregnancy OR antenatal, support) AND (women experiance)
Afterwards, we attempted additional searches using various combinations that
included the following key words as well: mother experience, role of partner, male
involvement support, pregnancy period.
Study selection
Systematic review included original studies written in the English language;
therefore, reviews, editorials, letters, and case reports were excluded from our
study. Studies included in the review contained quantitative and qualitative
research. Limitations not use regarding any study sample size did, study design,
and specific measures of outcomes used in the various studies.
Data extraction
From the studies that were included in our review,we extracted data regarding the
date of publication, the type of the study, the setting of the study, the study
population, the aim of the study, the follow-up period, the method used to assess
and measure psychological and psychosocial coping, and various coping
mechanisms.
This section assessed the writing and concentrates identified with the examination
ideas; uneasiness, dejection and related elements. Also, the writing survey utilized
web look investigations.

8
The sheltered parenthood activity, propelled in 1987 by WHO, UNICEF, UNFPA,
the World Bank and different associations set maternal wellbeing at the bleeding
edge of universal general wellbeing (Family care global, 2007)

Maternal wellbeing is a condition of change in physical, mental and social

prosperity of the mother; it is an asset for regular day to day existence of the
mother.

Maternal human services administrations contain an extensive variety of wellbeing

administrations given to the mother before pregnancy, during pregnancy, work and
after conveyance. Maternal wellbeing administrations incorporate the
accompanying, previously established inclination care, antenatal consideration
(ANC), Prevention of Mother to Child Transmission of HIV (PMTCT), safe
conveyance (intra-partum care); post natal consideration (PNC) and crisis obstetric
consideration/the executives of obstetric confusions. Anyway for this examination
maternal wellbeing administrations alludes to antenatal consideration, conveyance
and postnatal consideration.

2.2 Male Involvement in Maternal Health Care Services

It is vital to take note of that to build male contribution in maternal social insurance
administrations requires the suppliers to pick up inside and out information and
comprehension of the men's wellbeing viewpoints, conduct and practices.

Despite the fact that pregnancy isn't a disease, it makes a ton of physical and
passionate requests on the mother. The spouses and additionally other relatives
need to comprehend and value the uneasiness and tiredness that pregnancy may
9
cause to the pregnant lady. The mindfulness about the requests of pregnancy with
respect to the spouse and other relatives could result into the important help the
pregnant lady needs from the relatives including the husband.

The spouse is frequently the essential leader, and wife's financial reliance on her
significant other gives him more prominent effect on real family unit choices, as
was accounted for in Nepal by Britta and others (2004) where half of the ladies had
a ultimate choices about their very own social insurance made by their husbands
(Nepal Demographic and Health Survey, 2001). In light of the job men play in
basic leadership in the family, a few specialists recommend that male inclusion is
an exceptionally critical factor to consider in finding an answer for the three
fundamental components in charge of huge numbers of the maternal passing: 1) the
deferral in basic leadership to allude the patients to the suitable wellbeing office
where appropriate treatment could be taken; 2) absence of a framework for crisis
transport to guarantee that ladies who encounter obstetric entanglements get
auspicious treatment; and 3) delay in accepting treatment inside the medicinal
services office, which is here and there identified with taking care of the expenses
related to such crises.

Studies have proposed that male inclusion in maternal wellbeing results into
positive result for the pregnant lady as well as for the unborn tyke. Detailing
discoveries of their examinations Pagel et al (1999) and Mutale et al (2011)
presumed that absence of social help; particularly from the spouses or family
effectsly affects fetal development.

In a lot poorer nations a considerable lot of which have a man centric culture,
increment in male contribution during pregnancy has been viewed as a conceivable
10
factor in lessening the quantity of kids brought into the world with low birth
weight (Mira and UNICEF, 2010). Anyway notwithstanding these advantages of
male contribution in maternal human services benefits, the lion's share of
mediations and administrations to advance SRH including care during pregnancy
and labor in many nations have been only centered around ladies (Ntabona, 2002).
However it is essential to expect that for every one of the means prompting
maternal survival there is dependably a man remaining by the side of each lady
thumping at the door, previously, during and after every pregnancy (WHO, 1995).

2.3 Factors influencing Male Involvement in Maternal Health Care Services

Various components have been accounted for by a few analysts as being in charge
of affecting male association in maternal human services administrations. Some of
which are noted in the sections that follow in this fragment.

Generally, wellbeing suppliers and scientists in the field of conceptive wellbeing

have concentrated solely on ladies when arranging projects and administrations,
particularly with respect to FP, anticipation of undesirable pregnancies and of
hazardous premature births, and advancement of safe parenthood (WHO, 2001).

Anyway for motivations behind this dialog, factors influencing male inclusion in
maternal wellbeing administrations will be considered under the accompanying
classes

Social components: Men don't look for wellbeing data and administrations
because of conventional thoughts of manliness, where requesting assistance from a
medical caretaker or specialist is seen as an indication of shortcoming. Numerous
11
men feel it is their entitlement to reject contraception, to permit their accomplices
or even examine FP (EngenderHealth, 2008). These refusals can prompt
undesirable pregnancies, risky fetus removal and maternal passing or inability.
Announcing their discoveries from the investigation on ladies' self-sufficiency and
male contribution in Nepal, Britta at el, reasoned that higher ladies self-rule was
related with lower male inclusion in pregnancy wellbeing.

Socio – financial: Some men feel it is an obligation to encourage their spouses as

far as transport and in the event that they don't have methods for transport they see
no reason for escorting them while both are strolling. However as a rule in Africa
where the man is monetarily in position to give the essential necessities of life he
will in general have more than one spouse, which additionally contrarily influences
his readiness and capacity to escort the wife to look for consideration. Various
accomplice connections advances diverse interests for the man and his accomplices
and this will hamper conceivable outcomes for straightforward basic leadership on
maternal wellbeing administration issues notwithstanding inclusion in maternal
wellbeing administrations of every one of his spouses when required. Announcing
his discoveries Ratcliffe (2001) noticed that men are regularly associated with
various sexual connections that present a significant test to ripeness mindfulness
and conceptive wellbeing programs.

Liquor utilization by the men has additionally been noted to assumes an imperative
job in fending off men from contribution in maternal social insurance benefits as
more often than not they might be tanked, abandoning them with no cash or time to
encourage the required consideration.

12
Wellbeing administration factors: Generally inquire about demonstrates that
benefit related components could really compare to client related factors in
influencing male association in maternal human services administrations. The most
critical ones called attention to incorporate, long physical separation from the
wellbeing unit, absence of transportation, badly arranged facility hours, long
holding up time at the center, poor specialized and relational abilities. The
circumstance is exacerbated by the way that data got from wellbeing specialists on
maternal medicinal services is basically gone for ladies as was accounted for by
UNFPA (1999) in a few creating nations that ladies not men were the objectives of
regenerative wellbeing programs yet the majority of them are not monetarily or
socially situated to settle on choices about these issues without counseling their
spouses. This may effectively dishearten men from taking part in maternal
medicinal services benefits by the structure of administrations or by dispositions of
social insurance specialists.

In Turkey, it was seen that social insurance laborers were not supporting men who
needed to participate in maternal wellbeing administrations, a similar report
noticed that a great deal of men go to the center with their spouses 'yet it stops at
the entryway (Cigdem et al, 1999).

In their examination Bulut and Molzan(1995) revealed that societal meanings of

sex jobs, absence of data, and critical obstructions inside the medicinal services
framework itself as a portion of the issues refered to by customers as hindrances to
father's cooperation in baby blues care. Long working hours and troublesome in
requiring significant investment off work to go to administrations were
additionally refered to as reasons why numerous men would be not able take an
interest in ANC care administrations. While Mboizvo and Bassett (1996) expressed
13
that, inability to target men in projects has debilitated the effect of conceptive
wellbeing programs, since men can fundamentally impact their accomplice's
regenerative wellbeing basic leadership and utilization of wellbeing assets.

In Uganda, Maternal and Child Health (MCH) administrations implementers and

suppliers to a great extent disregarded the job of men. Anyway since the beginning
of HIV/AIDS pandemic, numerous endeavors are presently being made to achieve
men, particularly with respect to HIV/AIDS (UNFPA, 1999).

Arrangement issues: Greene et al (2002) noticed that scientists and conceptive

wellbeing specialist co-ops have would in general portray ladies' hindered
positions without men's jobs. This has brought about some conceptive wellbeing
programs intended to enhance ladies regenerative wellbeing to think about men as
a component of the issue and not part of the arrangement.

Correspondence issues: Studies demonstrate that there is a general absence of

enthusiasm with respect to men in a few nations Africa in their accomplices'
regenerative wellbeing (WHO, 2005). Men frequently don't approach data on
maternal medical problems and on their job in advancing maternal wellbeing
coming about into larger part of the men not to have adequate data and learning as
to maternal wellbeing.

Speaking with men has been accounted for by a few scientists to present
difficulties for projects, which verifiably have concentrated on serving ladies
(Young and Kol, 1999). It is difficult to configuration messages and materials that
men find influential, yet that likewise advance sex uniformity and ladies
strengthening. In Zimbabwe, most men misconstrued battle messages elevating
14
male contribution to imply that choices ought to exclusively be left to men (Young
and Kols, 1999). Once in a while couple discourse might be the issue, once there is
a correspondence breakdown for one reason or the other, the entire family work
falls flat. Kasolo and Ampaire (2000), featured a case of a breakdown in
correspondence among couples was the point at which they detailed that a few men
did not have any desire to talk about ANC participation with pregnant ladies since
they thought about pregnant ladies to bother a great deal.

Previous studies
Dan et al,. 2014 directed investigation meant to pick up a more profound
comprehension of their encounters of male association in their accomplices' social
insurance during pregnancy and labor. The discoveries may illuminate mediations
for expanding men's inclusion in regenerative wellbeing issues.they directed 16 top
to bottom meetings with men who went to the doctor's facility to take care of their
companions/accomplices admitted to Mulago National Referral Hospital. This
examination creates data on saw jobs, desires, encounters and difficulties looked
by men who wish to be associated with maternal medical problems, especially
during pregnancy and labor. There is disunity between the approach and practice
on male association in pregnancy and labor. Wellbeing framework factors that are
basic to advancing male inclusion in ladies' medical problems during pregnancy
and labor should be tended to.

Abiodun, et al., 2015 directed investigation meant to assess the desires for pregnant
ladies on the job of the male accomplice origination and delivery. A planned multi-
focus observational examination containing 506 pregnant ladies at eight wellbeing
offices in Ilorin, Nigeria from January to June 2014. Members were matured 17 to
49 years (mean 30.23±4.81), 82.4% want male accomplices organization during
15
antenatal center visits and 59.1% encountered this in file pregnancy. During work
and conveyance, 427(84.4%) need organization; 345(80.8%) picked the male band
together with 211(57.7%) trusting men will welcome the estimation of females a
while later albeit 27.9% dreaded the men may exasperate the wellbeing laborers,
72(14.2%) male accomplices went to past conveyance and 84.8% of the ladies
were happy with the experience. Parturient want male accomplices' essence at
conveyances however their past support was low; wellbeing office adjustments and
instruction for men are required to meet the wants.

Kennet, et al., 2016 led think about planned to decide male accomplices'
perspectives on their inclusion in maternal social insurance administrations. A
subjective report structure, which is exploratory, unmistakable and logical in
nature, was utilized. The populace involved 15 men whose accomplices had been
pregnant inside the most recent 2 years. A non-likelihood, purposive examining
strategy was utilized. Information were gathered through inside and out individual
meetings utilizing a voice recorder and a meeting plan control. Tesch's open coding
strategy was utilized to investigate data.The discoveries uncovered one noteworthy
subject, specifically that maternal medical problems are seen as a woman'sdomain;
and three sub-topics: culture and support in labor, male accomplices' work status,
and male accomplices' reluctance to take part in maternal medical problems.

16
 The method
3.1 Introduction
This part unmistakably characterizes the examination strategies used to lead the
investigation. The analyst clarifies how the essential data and to information
address the exploration goals and questions was gathered, introduced and broke
down. Reasons and supports for the examination configuration, inquire about
instruments, information sources, information accumulation systems, information
introduction methods and investigative strategies utilized are given.
3.2 Design:
Heppner et al (2004) describe a research design as a master plan which indicates
the strategies for conducting research or as a structured plan include a list of
procedure and specifications for controlling and performing a research project.
The design used in this study is qualitative phenomenological descriptive design.
Qualitative Research is primarily exploratory research. It is used to gain an
understanding of underlying reasons, opinions, and motivations. It provides
insights into the problem or helps to develop ideas or hypotheses for potential
quantitative research. Qualitative Research is also used to uncover trends in
thought and opinions, and dive deeper into the problem. Qualitative data collection
methods vary using unstructured or semi-structured techniques. Some common
methods include focus groups (group discussions), individual interviews, and
participation/observations. The sample size is typically small, and respondents are
selected to fulfill a given quota(Englander & Robinson, 2007).
This design used to study the experience of mothers include describing the aspect
of their pregnancy and husband support role also will be an indicator for the
women’s thought and feelings. (Barroso,. 2010). Semi-structured interviews
conducted with women’s.

17
women’s chosen primarily was based on a descriptive approach where our primary
goal is to provide some explanation how the women’s are experiencing their
husband in the care for them.
3.3 Giorgi – Phenomenological psychology:
The research method used here is Giorgi descriptive phenomenological. This
design suitable here is phenomenological psychology following Giorgi (1971)
because this method allows researcher to produce accurate descriptions of people
experience.
The motivation behind Giorgi's phenomenological inquire about is "to catch
as nearly as conceivable the manner by which the wonder is experienced (Giorgi,
2003). Phenomenology is utilized to explore for the mental implications that
establish the marvel in the existence universe of members.

The possibility of phenomenological look into is to consider how member

lives, that is the way they carry on and encounter circumstances (Giorgi, 1985).
Their experience depends on their life inside the setting in which the experience is
occurring.

The procedure of research in phenomenology to begins with depict the

circumstance as in everyday life to give understanding (Giorgi, 1985).
Why giorgi, phenomenology
Focusing specifically on psychological phenomenological approaches,
Giorgi (1989) has stated that four core characteristics hold across all variations:
The research is rigorously descriptive, uses the phenomenological reductions,
explores the intentional relationship between persons and situations, and discloses
the essences, or structures, of meaning immanent in human experiences through
the use of imaginative variation. Elsewhere Giorgi (1997), more straightforwardly,
18
argues that the phenomenological method encompasses three interlocking steps:
(1) phenomenological reduction, (2) description, and (3) search for essences.

3.4 Study Participants

Participants were the women’s who was previously get birth. The sample
was purposive sample in order to achieve the study aims.
3.4.1 Sample size
The sample for this study is a purposive sample (Polit, 2006). We included 5
womens and taken their consent to participate in the study. According to Giorgi
method are three interviews sufficient to achieve the purpose of the study (Giorgi,
1985). Semi structured interviews conducted with mothers.
3.5 Inclusion criteria
- The women age between 18 -30 years old.
- The women previously were get birth and not primigravida.
- The client doesn’t have any co morbid disorder.
- The women doesn’t have any mental or psychiatric disorder.
Exclusion criteria
-women can’t give consent form.
-women with mental or other disabling disorders
3.6 Setting
The setting of data collection was primary health clinics. In Nablus district -
Palestine.
3.7 Selection of the study instruments
We have the interview process that has been followed a semi structured
interview guide with different themes and underlying issues designed from the
essay purpose and question. Interview guide act as a support for that important
issues not be forgotten during the interview. It also serves as a designated by the
19
order in which different themes to be addressed. We use the interview guide as a
checklist to ensure that all the themes were taken up instead of letting the interview
wizard guide the conversation. This we believe contribute to the interviews
generally feel relax and natural, rather than a form of hearing.

3.8 Data collection

3.8.1 Interview
Interview subjects include women who is now pregnant
Comfortable, private room, free from interruptions in the clinic was used for
the duration of the interviews, the participants were reassured that confidentiality
would be maintained at all times. Participants were given
All interviews were audio taped with the consent of participants. The researcher
kept a field note book to pen write participants ‘unspoken words, and mannerisms
which could not be captured on tape to help during analysis.
The womens obtained a consent form, which retained, and an information
form, which they kept. The collection made through record interviews with a few
people (5 women). Each interview was between 30-45 min, but even shorter
descriptions exist, which in this study is that the interview began with a question
that the informant allowed to speak freely outside. We put as little questions as
possible in order not to affect their own assumptions. About follow the questions
asked there only to get a more detailed and deep description (Englander
&Robinson, 2007).
Sound quality was great on every single recorded meeting which permit that
the meetings effortlessly be translated without the pieces have tumbled off as a
result of commotion. The meetings interpreted verbatim and all recognizing
highlights evacuated to guarantee namelessness. All meetings initially tune in

20
through. We printed the meetings and afterward condensed comparatively to what
calls important merger task. A few statements spared in their unique frame.
Mother meet led the encounters of the mother's condition, its effect, dealing
with (adapting to life), impression of social help in regular daily existence and
family designs. Issues encompassing the customers everyday investigated, center
around their styles to deal with the conduct, and solicited subtleties from the
historical backdrop of the customer's present issues, the nature of the side effects
(recurrence, length, situational variety). What is the significance of customer's day
by day schedules, connection with family at home?
As a result, research focused on the holistic approach that provides to the
client at home. The interviewer has to avoid asking leading questions, but rather
seeking concrete descriptions of events, feelings, etc.
The initial question to the women: What is the role of your husband in your
pregnancy period?
Trustworthiness of the data ensured by appropriate sample selection to
ensure credibility, show the logic flow of the data collection and analysis, and by
verifying the findings with the informants to demonstrate fittingness or
transferability of the findings.
3.9 Pilot study
The above method tested in the pilot study. The pilot study involves one informant.
The researcher chooses One women, who asked to participate in the study. The
interviews were done in an isolated room in the clinic. The interview taped and the
text treated in accordance with the above analysis, which this pilot interview might
be included in the study sample.

3.10 Data Analysis

21
Giorgi Phenomenological clinicians investigations utilized. Information
investigation as indicated by Giorgi comprises of four ordinal advances where each
progression is an essential for the following (Giorgi, 1985b, 1997). Preceding the
investigation interpreted each meeting verbatim. All means in the examination
must be performed inside the phenomenological decrease (Englander and
Robinson 2007). (Giorgi, 1997).

The exploration ceaselessly for exposition composing address hypothesis,

technique, and reason for the article and the inquiry as lucid and not as discrete
parts. The examination of the material will be now in advancement from the time
we will begin with the gathering of material. The possibility of how we will
examine the gathered material has been with us from the earliest starting point of
the decision of subjective strategy. Planning the meeting guide is a breakdown of
the different topics notwithstanding foundation data has been about

Stage 1: Getting the feeling of the entire proclamation by perusing the whole
depiction

The whole meeting convention was perused a few times so as to get a feeling of
the entire experience. The thought was to acquire a portrayal, not to clarify or
develop (Giorgi, 1989). Wertz (1985) recommend that perusers should see crude
information and in addition handled information

The main perusing is done in the normal disposition (i.e., the ordinary frame of
mind) advised the analyst to all the more effectively distinguish and fundamentally
look at their own advantages, banks learned, speculations, theories and existential
presumptions about the marvel and after that set them in sections (Giorgi, 2005).
22
On the off chance that specific sections of the gathered material misty, it is
imperative that the creator does not cushion with their own understanding, but
rather returns to the interviewee and request elucidation portrayals. In the event
that the creator can't gather additional data about them will be later compelled to
portray the vulnerabilities that exist in the information. Ambiguities and
inconsistencies in the information may not decrease or announced the premise of
conceivable elucidations, however should dependably be portrayed in that
capacity. (Robinson and Englander 2007), (Giorgi, 1985, 1997

Stage 2: segregating meaning units inside a mental viewpoint

Subsequent to experiencing the initial step, Giorgi (1986) recommends that the
entire portrayal ought to be broken into a few sections to decide the significance of
the experience and these are communicated by the slices in the writings (Giorgi,
1985) or by the numbering of lines (Wertz,1985 ). Parts that were pertinent to the
wonder that is being examined were then distinguished. The way toward depicting
parts is alluded to as importance units, they express the member's very own
significance of the experience, and they just turned out to be significant when they
identify with the structure everything being equal (Ratner, 2001). A word, a
sentence or a few sentences may comprise an importance unit.

Each significance unit is constituent and in this way centers around the setting of
the content (Giorgi, 1985). The importance units are related with the scientist's
point of view and along these lines two analysts might not have indistinguishable
significance units (Giorgi&Giorgi, 2003a). This procedure happens inside what is

23
called decrease. It is imperative in phenomenological brain science to retain the
existential judgment about the experience of the member.

Stage 3: Transforming the subject's regular articulations into mental dialect

The scientist comes back to the majority of the importance units and questions
them for what they uncover about the wonder of intrigue. When the analyst gets a
handle on the pertinence of the subject's own words for the marvel, Researcher
communicates this significance in an as immediate way as could be expected under
the circumstances. This is known as the change of the subject's lived involvement
into direct mental articulation. This progression that makes it clears through the
depiction of the characteristic significance in the material. Moreover, the specialist
must clarify the certain importance of implications which the content focuses to,
i.e., make express what is verifiably given. For that change must be kept at an
illustrative dimension, it is basic, notwithstanding, does not go past what is
straightforwardly given in the information

Stage 4: Synthesizing changed significance units into a reliable proclamation of the

structure of the marvel.

- Making the implications units cognizant and amalgamations by relating

them to one another to have meaning proclamations.

Explicit articulations are composed for individual members and a procedure of

examination is utilized whereby normal subjects over these announcements are
evoked and after that shape a general auxiliary depiction which turns into the result

24
of the exploration., the genuine sentence structure on the researched wonder
portrayed (Robinson and Englander 2007), (Giorgi 1985, 1997).

Sentence structure comprises of the components distinguished in the past advance

and comprehended through their connections and the manner by which they are
identified with one another. Sentence structure is accomplished by the analyst as in
stage three make utilization of nonexistent varieties to touch base at the last
sentence structure that can't differ. All information must be considered and the
analyst should likewise have been adhering to a simply spellbinding dialect. In the
event that there are inconsistencies or ambiguities in the material will be portrayed
yet not clarified or comprehended as far as translations, speculations, theories or
other existential suspicions. On the off chance that the unique circumstance and
other logical components are important to the wonder should likewise be depicted.
There are three dimensions of which the structure can be depicted. The main
dimension is the individual structure that depends on a depiction of a source. The
second dimension is the general structure that can be accomplished by having
various depictions (normally three). At the third dimension, we locate the
widespread structure, which is situated on a philosophical dimension. To locate the
general structure is constantly alluring when it very well may be summed up to
other individuals encountering a similar kind of marvel

When the depiction of the mental structure of every individual had been
recognized, the scientist took a gander at articulations that can be taken as valid by
and large.
3.11 Saturation of the Data
According to Polit and Beck (2008) saturation met in the time of qualitative
data reach to a point where a sense of closure is met as further data yield as
25
repetitive data. Also Burns and Groove (2005) state that saturation of data in a
qualitative study is connected to the size of the sample which mostly dependent on
the thematic analysis that follows each interview transcribed or to continues until
no more themes generated from the interview data.
In the current study, data saturation occurred at the 9th mothers. the
researcher's conducted 2 more interviews to clarify the issue in the phenomena
under study and to ensure saturation.

3.12 Credibility and dependability

Matters relating to the implementation of interviews and analysis can say
something about the survey's reliability. Before the interviews, the authors write
down what they expected to find in the survey and be conscious of how their
backgrounds might be to color the survey. The authors could thus greater curb their
expectations, bracketing (Englander & Robinson, 2007).
The authors may, by making themselves aware of their own attitudes,
become a better listener who trying to put themselves aside and take the dialogue
partner seriously.
All interviews recorded on a tape and transcribed verbatim. This makes the
survey more credible than if the authors had only taken notes during the interview
(Stebbins, 2001).
The credibility of the data may be related to whether respondents tell the
authors truth (Stebbins, 2001). In this study authors are looking for experiences to
mothers of caring for client affected with schizophrenia. An experience is
subjective and thus true for the one who tells it.
The mothers asked if the authors really got something out of this when she
had told its history. It is important that the analysis and presentation of findings
made in a credible manner.
26
 The authors follow analysis model to Giorgi (1985) as described and tried to
be true to the stories of mothers and teachers. The authors selected in this study
using a phenomenological approach to the theme, this give the authors more
aspects of the findings. Using a developed analytical model, give an opportunity to
test the analysis that is done (Stebbins, 2001).
3.13 Evaluating the quality of phenomenological research
When presenting phenomenological research, its value is established by
honoring concrete individual instances and demonstrating some fidelity to the
phenomenon (Jackson, et al., 2008). Research reports may, for example, contain
raw data such as participants’ quotations providing an opportunity for readers to
judge the soundness of the researcher’s analysis.
The quality of any phenomenological study can be judged in its relative
power to draw the reader into the researcher’s discoveries allowing the reader to
see the worlds of others in new and deeper ways. Polkinghorne (1983) offers four
qualities to help the reader evaluate the power and trustworthiness of
phenomenological accounts: vividness, accuracy, richness and elegance. Is the
research vivid in the sense that it generates a sense of reality and draws the reader
in? Are readers able to recognize the phenomenon from their own experience or
from imagining the situation vicariously? In terms of richness, can readers enter
the account emotionally? Finally, has the phenomenon been described in a
graceful, clear, poignant way Developing trustworthiness of a qualitative study,
credibility, dependability, confirmability, and transferability.
3.13.1 Credibility: Credibility focuses on the truth and value relating to the
findings of the study and the representation of these (Topping 2006). The
researcher, through the use of semi-structured interviewing techniques, tape
recordings of the interviews and transcriptions of verbatim quotes, increased the

27
accuracy of the descriptions of participants’ experiences and therefore increased
the credibility of the findings (Streubert& Carpenter 2010).
3.13.2 Dependability is concerned with the ability of the data to remain stable
over time, would the study findings be replicated if undertaken with similar
participants in a similar context. Credibility cannot be attained in the absence of
dependability. The researcher used an audit trail to enhance the dependability of
the study. It involved tracking and recording all decisions which could influence
the study so an outside individual can examine the data (Streubert et al 2010). The
researcher is keeping all recordings and of all decisions regarding the study with all
other information under lock and key.
3.13.3 Conformability refers to the data representing the information participants
provided. There were no biases or subjectivity in the study; the findings
represented the participants voice (Polit& Beck 2010). The researcher upheld this
principle by clarifying all information with the participants. The researcher made a
follow up interviews to two participants.
3.13.4 Transferability involves the extent to which the findings of a qualitative
study can be useful to similar groups or situations (Parahoo 2006). The study will
enhance knowledge and subsequently result in the developments and practice of
care giving. It should be understood that to achieve the robustness of study,
accurate records were kept of all interviews and interactions with participants, as
the careful recording of data was crucial to the study. The researcher considered at
all times, strict attention to details, adhering to procedures and through consistency
and accuracy throughout the research process.
3.13.5 Autonomy: Participants were given clear unambiguous information
regarding the research, comprehended the information and the option to consent or
decline participation voluntarily as Polit and Beck 2010 stated. Informed consent
was sought from every participant. Information sheet was also explained to all
28
participants and were provided with copies of the consent form. Polit and Beck
(2010) advises the consent form should be clear, concise and easy to read with no
jargon. These information sheets and consent forms were stored under lock and
key and only the author and her two supervisors had access to. The researcher also
explained to participants they have the right to withdraw from the study at any
time.
3.13.6 Confidentiality: Confidentiality is essential; the researcher will safeguard
participant‘s identities and responses from public disclosure (Stake, 2010). The
researcher assured participants of confidentiality and was respected at all times.
Pseudonyms were used throughout the study. Participants were assigned an
identification number which was used throughout the study and no identifying
information was entered onto computer files. Encryption technologies were used to
protect electronic data in keeping with the Policy on Good Research Practice
(Stake, 2010).
3.13.7 Beneficence: one ethical principle in research is beneficence, where the
onus is on researchers to minimize harm and maximize benefits for the participants
themselves, other individuals or society as a whole (Polit and Beck 2010). The sole
aim of this study was to be of benefit. The researcher is certain that this study will
be of benefit to the nursing profession and subsequently improve the lives of
informal caregivers of individuals with schizophrenia.
3.13.8 Non-maleficence: Research should not cause any harm to participants
either physical or psychological (Parahoo, 2006). The researcher, therefore,
listened attentively to participants, provided an opportunity for them to voice any
concerns or queries they have regarding the study.
3.14 Ethical consideration
The study approved by the Ministry of Education and An-Najah National
University Research Ethics Boards (IRB). Consent obtained from informants to
29
take part in the study. (Annex II). The sources, who wish to visit, educated by the
questioner, both verbally and in composing (Annex I) with the end goal of the
meeting and study, in the meantime, the assention is set aside a few minutes of the
meeting. The member educated that the meeting led in a private room which
simply the witness and the questioner present and that the meeting recorded by
recording device and that no people can be recognized after content handling. Data
on all groups and prints the content put away under the present standards in bolted
cupboards. The witnesses likewise educated of the deliberate nature to take part in
the examination and that whenever can stop the meeting and that these not
influence them at all. The information put away until the point when the
examination is finished. From that point onward, all the material from the meetings
be obliterated

On the data sheet, there are phone numbers to questioner and chief about any
issues raised if the source feels the requirement for further discussion. These
contemplations depend on the Helsinki Agreement (World Medical Association.
Helsinki Declaration, 2008) on moral rules for nursing research on volunteerism, to
pull back from the undertaking, potential dangers or inconvenience, obscurity,
classification, and contacts for any data required.

Phenomenological contemplates are constantly review (Parahoo, 2006). So it is

with this investigation. The moms recount their accounts of undertakings. To
develop the narratives appear to be a characteristic human process that helps
people in understanding the encounters and themselves (Stake, 2010). How might
it be a wellbeing impact for sources to take an interest in the study? A few
investigations were done throughout the years and that says it is huge, positive,
predictable and recognizable connection between discussing candidly troublesome
30
encounters and wellbeing. To develop their very own history is a kind of
information that sorts out the enthusiastic impacts of understanding and
additionally involvement in itself.

"Having the capacity to tell their history" can be experienced as recuperating in

itself. In the meantime, it may give a few advantages for different guardians and
instructors in indistinguishable circumstance from an entirety.

Privacy of the records and data referenced in the start of the meeting. The sources'
personalities ensured completely. No names or other data that may uncover
sources' personalities announced.

31
Chapter four: The results
4.0 Introduction
This chapter presents the results about the experiences of women for their
husband support during pregnancy in Nablus District. 5 women were interviewed
and talk about their experiences regarding pregnancy. Data collected through
Indepth interviews with women from 15th of November to 30th of November 2018.
Gorgi phenomenological analysis was employed notwithstanding field notes on the
practices during meeting, a portion of the responses like peculiarity, tears of the
members that couldn't be Reordered. The information were investigated so as to
give profound translation to more profound comprehension of ladies encounters,
the deciphered composed information was perused increasingly more to recognize
thoughts, words, ideas, notices, and subjects that oftentimes showed up. The topics,
ideas, and words were and checked and contrasted with all transcript and found
with be soaked and steady before the finish of the forward ladies meet. After
information end up and saturated, more 1 interviews were led as follow up
meetings to guarantee immersion and to elucidate issues that were accounted for
by a few members in prior meetings. The topics and sub topic were assembled to
mirror the encounters of the moms (Table 4.2).

four principle topics were produced with multi sub theme. The theme
distinguished from the meeting examined here utilizing the ladies 'claim words.

The ladies were talked with utilizing numerical game plan and the
discoveries are exhibited utilizing W numerical game plan to customize the
verbatim report and disguise the moms 'personality. The notice of moms utilizing
code name as the accompanying, W1, W2,… , W5

32
4.2 Result of the study
The finding of the study presented in paragraphs according to theme and sub
themes.
4.2.2 General profile of participants
The characteristics of the ladies participated included the age, educational
background (Table 4.1).

Table 4.1: Demographic variables of women’s participated

Number of family
Women Age Education
members
W1 19 University 2
W2 27 High school 5
W3 22 High school 4
W4 25 Collage 3
W5 29 High school 6

4.2.3 Themes and sub themes obtained from the interviews

33
 From the experiences narrated by the women’s, 4 main themes and 18 sub
themes emerged from the analysis of the data. The data obtained from mothers
were transcribed verbatim. These are presented in the following table.
Table 4.2: Themes and categories
Major Themes Sub themes
Support for Coping Nice words
with pregnancy
Sharing

Understanding

Work my works
Own resources Family

Friends

Workmates and employers

Act of love Love

Be with me

Positive
Economic support Straggle

New resources

Prepare for our baby

34
How do you see husband role in general?
The finding relived, that the perfect father is portrayed by members as being open
(present, accessible, a cooperative person) and mindful (is concerned, keeps up
association with the lady conveying the kid paying little respect to the organization
status, and is a parental figure, supplier or defender). The perfect father anticipates
that and needs will be locked in (thinks about the pregnancy and the coming
youngster, needs to take in more about the procedure, needs to be included and
needs to be upheld by the wellbeing framework to achieve his jobs). Men are ready
and anxious to help their accomplices/wives/life partners as of now.
W1: I can talk about my husband, he giving us the financial support,
occupational role, and security role, supporter, family leader.
W2: the male are half of the society, they are responsible for every thing
beside the women
W3: I see the male as the leader, adviser, manager with out their effert
we can’t do any things

husband support

W3 in General my husband support me in all aspects emotionally,

psychologically, physically, his presence in my life give my life different
taste, happenies, also during pregnancy he support me so so much, he
behave as responsible man, he understand my complains, he don’t
complain of my strange behaviours, he accept me, he support me,
without him I don’t know what to do.

35
 W2: with my husband and my mum support they make me love
pregnancy, my husband in our home and my mum when my husband in
the work, this give me the feeling of strong, confidence, and happiness.
Also There general consensus was that should a man become involved with a
pregnant woman, he would also accept “partnership” in the pregnancy and (as her
“partner”). This was perceived as a man’s obligation. If the man was responsible
for the pregnancy, he was required to demonstrate that responsibility by supporting
and caring for the woman during pregnancy and childbirth.
This obligation extended to any man involved in a relationship with a pregnant
woman.

W5: my husband behave and dealing with me in good way, but all the
time he in the work he go to work at 6am and come back 8PM, he is
good, and accept me but I don’t complain in front of him because he
complain so much in his work and I don’t want to increase his complain.
W4:husband has the major and the big roll in support the women, the
women may be his mother, sister or wife but when girl married her
husband become the main support for her in many aspect and mostly
psychological aspect, to say word encourage her, every time my husband
says to me when our moon will come, she will be look like her mother,
this give me very very good support.
W1: the husband can support his wife by many ways the easiest one is
nice word for her, word make her feeling that her husband is feeling of
her.
W2: the most important in pregnancy in husband support, the pregnancy
is not easy but it pass easly with support

36
Male involvement as an act of love
W3: my friend, family also support me, they help me to cope but the main
support is my husband, he all the time with me, what I need, he offer,
when I am in 1st trimester I complain from nausea and vomiting he
understand that and he do all the eating or buy from out side.

W2: The psychological support is the main aspect women need, the nice
words is so support for me, I like that, this words give me positive charge
toward living my life comfortable,
W5: My psychological status affected so much in pregnancy, he is the 1st
person who can change to better, I share with him all moment in my life,
when he in work I told him everything on phone, he take care of our
children.
W1: he have unexplained fear, but this make me feel positive, he fear on
my health, and my baby, he give me what I need when I need.

Financial support
W3: The main barrier is his work, he work in Israel, he work 5 days per
week and sleep out, but through this way he try to improve our
economical situation and make better life for us. He struggle to make us
feel happy, he do what he can do.
W5: from the time we marriage before 8 years he still try to offer better
life for us, he is the main financial support for us.

37
Chapter five: the discussion
This study has provided insights on how male involvement is perceived by
the Palestinian community and health care providers in Nablus District,
The finding from interview showed the Men as a key role in supporting
women. They still remain an authority in decision making, supporting.
All the women in the study agree that the men has the major role in supporting
their wives in pregnancy this result consistent with study done in Northern
Nigerian community on birth preparedness by Iliyasu (2010), it was identify that
the common aspects of husband participation during pregnancy was psychological
support, financial support, and nutrition.
and birth preparedness in terms of material support and transport arrangements.
Men’s involvement pregnancy and childbirth plays a vital role in the safety of their
female partners’ pregnancy and childbirth, by ensuring access to care and
provision of emotional and financial support and guarantying women’s access to
reproductive health services in general. However, in agreement with prior research,
personal, family, societal and health system factors limit male involvement.
Husbands contribution during pregnancy assumes a vital role in the
wellbeing of their wives pregnancy and labor, by guaranteeing access to care and
arrangement of psychological and financial support and guarantying ladies'
entrance to regenerative wellbeing administrations when all is said in done.
The study shows that despite presence of a supportive by husbands, they
experience stressful situations in their attempts to be involved during pregnancy
when they have fear and restrict activity of their wives. This consistent with study
of

38
Emotional support
Most women think about that pregnancy is an upsetting and testing period
for ladies and that spouses could enhance this experience for their wives with their
passionate help. Most female members felt that a decent spouse is one who
underpins his significant other under any condition. For instance, a spouse may not
ready to do positioning or may maintain a strategic distance from her better half in
light of heaving and sickness or abhorrences caused by pregnancy, husband ought
not deny passionate help for the mother or view her as to blame. By offering
support, he takes this weight off his significant other's shoulders and encourages
her to endure the issues. Most hopeful spouses were ignorant of the progressions
caused by pregnancy and the need to sympathize with their wives during this
period since they viewed pregnancy as normal for ladies and not essentially not the
same as non-pregnancy.
All women recognized that giving significant serenity to the spouse during
pregnancy is an essential need of moms during the pregnancy time. During
pregnancy, men should demonstrate their spouses that they are willing accomplices
during the pregnancy. A spouse ought to give a sheltered and serene condition in
the house, keep away from pressure and help his significant other to have a
positive picture of her body. He should endeavor to diminish pressure and concerns
felt by his better half by consoling her, getting her to the healing facility on time,
giving the expense of conveyance and taking an interest being taken care of by the
newborn child. He ought to likewise perceive the impacts of her condition when
visiting others or having visitors and regards her choices in such manner.
Most womens believed that during pregnancy, the husband should
participate in the cooking and cleanup and handle heavy household jobs. They
should adopt a positive role in the care and rearing of the children and in preparing
other children to accept the new infant this In line with the results of previous
39
studies in Iran and Kenya, the present study found that most women emphasized
that men should lower their expectations of their wives during pregnancy with
regard to housework and cooking and that men emphasized their role in providing
the necessities of life and making money (Kwambai, et al., 2014; Mirzaii, et al.,
2012).
The emotional support of the husband was another aspect of participation in
perinatal care that was proposed by the participants. A husband’s ability to
empathize with his wife and provide a safe and peaceful environment free of
aggression and restrictions was also discussed by women. The studies of
Mortazavi, Mirzaii, et al., (2012) and Simbar et al. (2009) revealed that emotional
support for women and her need for love and affection are the most important
aspect of the father’s participation in perinatal care. A study in China showed that a
husband’s emotional support was the most influential in decreasing the risk of
postpartum depression (Ergo, et al,. 2011). This indicates that men and women
have realized the importance of psychological health during the perinatal period
and that the husband is the best provider of his wife’s emotional needs. It might the
effect of information transmitted through social media (Sayakhot, 2016).

40
Recommendation for future research

 To do same research with involvement with male interview.

 To do identify factors that promote support in pregnancy

Limitation of the study

In first the lack of experience in research in general and qualitative research in
specific because qualitative research need more knowledge on how to make
interview, analyze qualitative data.
The second limitation is sample recruitment because when we said to women that
we want to record their voice most of them refuse.

41
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