{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T09:09:01Z","timestamp":1788944941230,"version":"build-2803163510"},"reference-count":57,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Foundation for Advancement of Haitian Midwives"},{"DOI":"10.13039\/100009776","name":"McMaster University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100009776","id-type":"DOI","asserted-by":"crossref"}]},{"name":"GoFundMe crowdsourcing"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Qual Health Res"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>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\u201324\u00a0years 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.<\/jats:p>","DOI":"10.1177\/10497323251347161","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T07:30:47Z","timestamp":1753255847000},"page":"1311-1328","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Navigating the Perils of Pregnancy and Childbirth Among Youth in La Pointe, Haiti: Insights Captured Through Community Photovoice Research"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1246-4959","authenticated-orcid":false,"given":"Tonya A.","family":"MacDonald","sequence":"first","affiliation":[{"name":"McMaster University"},{"name":"McMaster University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Carm\u00e8le","family":"Charles","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Montr\u00e9al"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ol\u00e8s","family":"Dorcely","sequence":"additional","affiliation":[{"name":"Centre M\u00e9dical B\u00e9raca"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7oise D.","family":"Volcy Bonne Anney","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Montr\u00e9al"},{"name":"Centre M\u00e9dical B\u00e9raca"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Medge Dona","family":"Mular","sequence":"additional","affiliation":[{"name":"Centre M\u00e9dical B\u00e9raca"},{"name":"Universit\u00e9 d\u2019\u00c9tat d\u2019Ha\u00efti"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lovenska","family":"Sylvestre","sequence":"additional","affiliation":[{"name":"Centre M\u00e9dical B\u00e9raca"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose Andrele","family":"Bien Aim\u00e9","sequence":"additional","affiliation":[{"name":"Centre M\u00e9dical B\u00e9raca"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth K.","family":"Darling","sequence":"additional","affiliation":[{"name":"McMaster University"},{"name":"McMaster University"},{"name":"McMaster University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saara","family":"Greene","sequence":"additional","affiliation":[{"name":"McMaster University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Moll","sequence":"additional","affiliation":[{"name":"McMaster University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Logie","sequence":"additional","affiliation":[{"name":"University of Toronto"},{"name":"Centre for Gender & Sexual Health Equity"},{"name":"Water, Environment and Health of United Nations University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Mbuagbaw","sequence":"additional","affiliation":[{"name":"McMaster University"},{"name":"McMaster University"},{"name":"McMaster University"},{"name":"Father Sean O\u2019Sullivan Research Centre"},{"name":"Yaound\u00e9 Central Hospital"},{"name":"Stellenbosch University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,23]]},"reference":[{"key":"e_1_3_6_2_1","doi-asserted-by":"publisher","DOI":"10.15171\/hpp.2019.35"},{"key":"e_1_3_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11528-021-00642-4"},{"key":"e_1_3_6_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/2159676X.2019.1628806"},{"key":"e_1_3_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/capr.12360"},{"key":"e_1_3_6_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-019-2361-0"},{"key":"e_1_3_6_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-018-5335-7"},{"key":"e_1_3_6_8_1","volume-title":"Trauma-informed care implementation resource center: What is trauma-informed care?","author":"Center for Health Care Strategies","year":"2024","unstructured":"Center for Health Care Strategies. (2024). Trauma-informed care implementation resource center: What is trauma-informed care? https:\/\/www.traumainformedcare.chcs.org\/what-is-trauma-informed-care\/"},{"key":"e_1_3_6_9_1","volume-title":"The world factbook-Haiti","author":"Central Intelligence Agency (CIA)","year":"2025","unstructured":"Central Intelligence Agency (CIA). (2025). The world factbook-Haiti. https:\/\/www.cia.gov\/the-world-factbook\/countries\/haiti\/#transnational-issues"},{"key":"e_1_3_6_10_1","volume-title":"Centre M\u00e9dical B\u00e9raca: About CMB","author":"Centre M\u00e9dical B\u00e9raca","year":"2019","unstructured":"Centre M\u00e9dical B\u00e9raca. (2019). Centre M\u00e9dical B\u00e9raca: About CMB. https:\/\/www.cmbhaiti.org\/"},{"key":"e_1_3_6_11_1","volume-title":"Designing and conducting mixed methods research","author":"Creswell J. W.","year":"2018","unstructured":"Creswell J. W., Plano Clark V. L. (2018). Designing and conducting mixed methods research (3rd ed.). Sage.","edition":"3"},{"key":"e_1_3_6_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0020872811414038"},{"key":"e_1_3_6_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-019-0843-1"},{"key":"e_1_3_6_14_1","doi-asserted-by":"publisher","DOI":"10.21149\/10938"},{"key":"e_1_3_6_15_1","volume-title":"\u201cHaiti age structure\u201d","author":"IndexMundi","year":"2019","unstructured":"IndexMundi. (2019). \u201cHaiti age structure\u201d. https:\/\/www.indexmundi.com\/haiti\/age_structure.html"},{"key":"e_1_3_6_16_1","volume-title":"\u201cHaiti age structure\u201d","author":"IndexMundi","year":"2020","unstructured":"IndexMundi. (2020). \u201cHaiti age structure\u201d. https:\/\/www.indexmundi.com\/haiti\/age_structure.html"},{"key":"e_1_3_6_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/00224499.2017.1292493"},{"key":"e_1_3_6_18_1","volume-title":"Haiti enqu\u00eate mortalit\u00e9, morbidit\u00e9 et utilisation des services 2016-2017 - EMMUS-VI","author":"Institut Ha\u00eftien de l\u2019Enfance [IHE\/Haiti]","year":"2018","unstructured":"Institut Ha\u00eftien de l\u2019Enfance [IHE\/Haiti]. (2018). Haiti enqu\u00eate mortalit\u00e9, morbidit\u00e9 et utilisation des services 2016-2017 - EMMUS-VI. https:\/\/dhsprogram.com\/pubs\/pdf\/FR326\/FR326.pdf"},{"key":"e_1_3_6_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2023-011957"},{"key":"e_1_3_6_20_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.20.283861"},{"key":"e_1_3_6_21_1","doi-asserted-by":"publisher","DOI":"10.4236\/aasoci.2024.144012"},{"key":"e_1_3_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(23)00247-4"},{"key":"e_1_3_6_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/1609406918757631"},{"key":"e_1_3_6_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0303168"},{"key":"e_1_3_6_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-018-1881-3"},{"key":"e_1_3_6_26_1","volume-title":"Toward a trauma- and violence-informed research ethics module: Considerations and recommendations","author":"Nonomura R.","year":"2020","unstructured":"Nonomura R., Giesbrecht C., Jivraj T., Lapp A., Bax K., Jenney A., Scott K., Straatman A. L., Baker L. (2020). Toward a trauma- and violence-informed research ethics module: Considerations and recommendations. Western University Centre for Research & Education on Violence Against Women & Children."},{"key":"e_1_3_6_27_1","doi-asserted-by":"publisher","DOI":"10.1080\/13691058.2017.1293844"},{"issue":"4","key":"e_1_3_6_28_1","first-page":"1247","article-title":"A debt of dishonor","volume":"102","author":"Oosterlinck K.","year":"2022","unstructured":"Oosterlinck K., Panizza U., Weidemaier W. M. C., Gulati M. (2022). A debt of dishonor. Boston University Law Review, 102(4), 1247\u20131275. https:\/\/papers.ssrn.com\/sol3\/papers.cfm?abstract_id=4097278","journal-title":"Boston University Law Review"},{"key":"e_1_3_6_29_1","volume-title":"Haiti adolescent and youth health country profile","author":"Pan American Health Organization","year":"2017","unstructured":"Pan American Health Organization. (2017). Haiti adolescent and youth health country profile. https:\/\/www.paho.org\/adolescent-health-report-2018\/images\/profiles\/Haiti-PAHO\/Adolescents\/and\/Youth\/Health\/Country\/Profile\/V5.0.pdf"},{"key":"e_1_3_6_30_1","volume-title":"Core indicators portal: Region of the americas","author":"Pan American Health Organization","year":"2023","unstructured":"Pan American Health Organization. (2023). Core indicators portal: Region of the americas. EIH Department of Evidence and Information for Action in Health. https:\/\/opendata.paho.org\/en\/core-indicators\/core-indicators-dashboard"},{"key":"e_1_3_6_31_1","volume-title":"Country profile: Haiti-health situation","author":"Pan American Health Organization","year":"2024","unstructured":"Pan American Health Organization. (2024). Country profile: Haiti-health situation. https:\/\/hia.paho.org\/en\/country-profiles\/haiti#situation"},{"key":"e_1_3_6_32_1","volume-title":"Open data: Core indicators","author":"Pan American Health Organization","year":"2025","unstructured":"Pan American Health Organization. (2025). Open data: Core indicators. https:\/\/opendata.paho.org\/en\/core-indicators\/core-indicators-dashboard"},{"key":"e_1_3_6_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-002526"},{"key":"e_1_3_6_34_1","volume-title":"Handling qualitative data: A practical guide","author":"Richards L.","year":"2015","unstructured":"Richards L. (2015). Handling qualitative data: A practical guide (3rd ed.). Sage.","edition":"3"},{"key":"e_1_3_6_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(23)00468-0"},{"key":"e_1_3_6_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/tct.13242"},{"key":"e_1_3_6_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-024-11817-z"},{"key":"e_1_3_6_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-016-0247-7"},{"issue":"36","key":"e_1_3_6_39_1","first-page":"22","article-title":"Too far to walk: Maternal mortality in context","author":"Thaddeus S.","year":"1991","unstructured":"Thaddeus S., Maine D. (1991). Too far to walk: Maternal mortality in context. Newsletter (Women\u2019s Global Network on Reproductive Rights), (36), 22\u201324. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/12284530","journal-title":"Newsletter (Women\u2019s Global Network on Reproductive Rights)"},{"key":"e_1_3_6_40_1","volume-title":"The TRUST Code - A global code of conduct for equitable research partnerships","author":"TRUST","year":"2018","unstructured":"TRUST. (2018). The TRUST Code - A global code of conduct for equitable research partnerships. https:\/\/www.globalcodeofconduct.org\/"},{"key":"e_1_3_6_41_1","volume-title":"Definition of youth","author":"United Nations","year":"2019","unstructured":"United Nations. (2019). Definition of youth. https:\/\/undesadspd.org\/Youth.aspx"},{"key":"e_1_3_6_42_1","volume-title":"A window of opportunity in Haiti","author":"United Nations","year":"2024","unstructured":"United Nations. (2024). A window of opportunity in Haiti. https:\/\/www.un.org\/en\/un-chronicle\/window-opportunity-haiti"},{"key":"e_1_3_6_43_1","volume-title":"Health equity report 2016: Analysis of reproductive, maternal, newborn, child and adolescent health inequities in Latin America and the Caribbean to inform policymaking","author":"United Nations Children\u2019s Fund","year":"2016","unstructured":"United Nations Children\u2019s Fund. (2016). Health equity report 2016: Analysis of reproductive, maternal, newborn, child and adolescent health inequities in Latin America and the Caribbean to inform policymaking [Summary Report]."},{"key":"e_1_3_6_44_1","volume-title":"Country office annual report 2022: Haiti","author":"United Nations Children\u2019s Fund","year":"2022","unstructured":"United Nations Children\u2019s Fund. (2022). Country office annual report 2022: Haiti. UNICEF."},{"key":"e_1_3_6_45_1","volume-title":"Maternal mortality","author":"United Nations Children\u2019s Fund","year":"2023","unstructured":"United Nations Children\u2019s Fund. (2023). Maternal mortality. UNICEF. https:\/\/data.unicef.org\/topic\/maternal-health\/maternal-mortality\/#:\u223c:text=Definition%3A\/The\/maternal\/mortality\/ratio,during\/the\/same\/time\/period"},{"key":"e_1_3_6_46_1","unstructured":"United Nations Development Programme. (2022). Human development report 2021\/22: Uncertain times unsettled lives: Shaping our future in a transforming World."},{"key":"e_1_3_6_47_1","volume-title":"Human development reports: Haiti-Country data","author":"United Nations Development Programme","year":"2024","unstructured":"United Nations Development Programme. (2024). Human development reports: Haiti-Country data. https:\/\/hdr.undp.org\/data-center\/specific-country-data#\/countries\/HTI"},{"key":"e_1_3_6_48_1","doi-asserted-by":"publisher","DOI":"10.1177\/109019818801500402"},{"issue":"2","key":"e_1_3_6_49_1","first-page":"171","article-title":"Empowerment through photo Novella: Portraits of participation","volume":"21","author":"Wang C.","year":"1994","unstructured":"Wang C., Burris M. A. (1994). Empowerment through photo Novella: Portraits of participation. Health Education & Behavior, 21(2), 171\u2013186. https:\/\/doi.org\/10.1177\/109019819402100204","journal-title":"Health Education & Behavior"},{"key":"e_1_3_6_50_1","doi-asserted-by":"publisher","DOI":"10.1177\/109019819702400309"},{"key":"e_1_3_6_51_1","doi-asserted-by":"publisher","DOI":"10.1177\/109019810102800504"},{"key":"e_1_3_6_52_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapro\/13.1.75"},{"key":"e_1_3_6_53_1","doi-asserted-by":"publisher","DOI":"10.1080\/09650792.2016.1169198"},{"key":"e_1_3_6_54_1","volume-title":"Population, total-Haiti","author":"World Bank","year":"2023","unstructured":"World Bank. (2023). Population, total-Haiti. https:\/\/data.worldbank.org\/indicator\/SP.POP.TOTL?locations=HT"},{"key":"e_1_3_6_55_1","volume-title":"Evaluating the quality of care for severe pregnancy complications: The WHO near-miss approach for maternal health","author":"World Health Organization","year":"2011","unstructured":"World Health Organization. (2011). Evaluating the quality of care for severe pregnancy complications: The WHO near-miss approach for maternal health."},{"key":"e_1_3_6_56_1","volume-title":"Ethical and safety recommendations for intervention research on violence against women: Building on lessons from the WHO publication \u201cPutting women first: Ethical and safety recommendations for research on domestic violence against women\u201d","author":"World Health Organization","year":"2016","unstructured":"World Health Organization. (2016). Ethical and safety recommendations for intervention research on violence against women: Building on lessons from the WHO publication \u201cPutting women first: Ethical and safety recommendations for research on domestic violence against women\u201d."},{"key":"e_1_3_6_57_1","volume-title":"Maternal morbidity and well-being","author":"World Health Organization","year":"2024","unstructured":"World Health Organization. (2024). Maternal morbidity and well-being. https:\/\/www.who.int\/teams\/maternal-newborn-child-adolescent-health-and-ageing\/maternal-health\/maternal-morbidity-and-well-being"},{"key":"e_1_3_6_58_1","volume-title":"Data: Health statistics - Haiti","author":"World Health Organization","year":"2025","unstructured":"World Health Organization. (2025). Data: Health statistics - Haiti. https:\/\/data.who.int\/countries\/332"}],"container-title":["Qualitative Health Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10497323251347161","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10497323251347161","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10497323251347161","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T08:44:18Z","timestamp":1788943458000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10497323251347161"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,23]]},"references-count":57,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1177\/10497323251347161"],"URL":"https:\/\/doi.org\/10.1177\/10497323251347161","relation":{},"ISSN":["1049-7323","1552-7557"],"issn-type":[{"value":"1049-7323","type":"print"},{"value":"1552-7557","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,23]]}}}