Drivers of adolescent experiences with facility-based childbirth in rural northern Uganda: application of the Cultural Health Capital Theory

Background/Aims Adolescents are more likely to report negative experiences during facility-based childbirth than older women, but evidence on how adolescents are treated is limited. The aim of this study was to explore drivers of adolescent experiences with facility-based childbirth in rural northern Uganda. Methods This qualitative descriptive study was conducted among 14 purposively sampled adolescents aged 15–19 years who gave birth in public health facilities in rural northern Uganda between 15 July and 31 August 2023. In-depth, semi-structured interviews were used to collect data, which were analysed using an inductive thematic approach guided by the Cultural Health Capital Theory. Results The average age of the study participants was 18.7 years, and more than three-quarters of the participants (78.6%) were primiparous. Participants' negative experiences during facility-based childbirth were driven by a lack of birthing necessities, younger age and perceived low social status. Positive experiences were driven by passive compliance, calm demeanor, relational skills, possession of birthing necessities, cleanliness and neatness. Conclusions Adolescents' experiences during facility-based childbirth were shaped by a complex interplay of social, relational and resource-related factors. These findings highlight the need for tailored interventions that address resource gaps, promote equitable care, and foster a supportive and respectful maternity care environment for adolescents. Implications for practice Healthcare professionals should provide adolescent-responsive, respectful maternity care that addresses age- and social status-related inequities, ensures access to essential birthing resources and strengthens provider–adolescent communication and relational skills.