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Narrative Analysis – Types, Methods and Examples

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Narrative Analysis

Definition:

Narrative analysis is a qualitative research methodology that involves examining and interpreting the stories or narratives people tell in order to gain insights into the meanings, experiences, and perspectives that underlie them. Narrative analysis can be applied to various forms of communication, including written texts, oral interviews, and visual media.

In narrative analysis, researchers typically examine the structure, content, and context of the narratives they are studying, paying close attention to the language, themes, and symbols used by the storytellers. They may also look for patterns or recurring motifs within the narratives, and consider the cultural and social contexts in which they are situated.

Types of Narrative Analysis

Types of Narrative Analysis are as follows:

Content Analysis

This type of narrative analysis involves examining the content of a narrative in order to identify themes, motifs, and other patterns. Researchers may use coding schemes to identify specific themes or categories within the text, and then analyze how they are related to each other and to the overall narrative. Content analysis can be used to study various forms of communication, including written texts, oral interviews, and visual media.

Structural Analysis

This type of narrative analysis focuses on the formal structure of a narrative, including its plot, character development, and use of literary devices. Researchers may analyze the narrative arc, the relationship between the protagonist and antagonist, or the use of symbolism and metaphor. Structural analysis can be useful for understanding how a narrative is constructed and how it affects the reader or audience.

Discourse Analysis

This type of narrative analysis focuses on the language and discourse used in a narrative, including the social and cultural context in which it is situated. Researchers may analyze the use of specific words or phrases, the tone and style of the narrative, or the ways in which social and cultural norms are reflected in the narrative. Discourse analysis can be useful for understanding how narratives are influenced by larger social and cultural structures.

Phenomenological Analysis

This type of narrative analysis focuses on the subjective experience of the narrator, and how they interpret and make sense of their experiences. Researchers may analyze the language used to describe experiences, the emotions expressed in the narrative, or the ways in which the narrator constructs meaning from their experiences. Phenomenological analysis can be useful for understanding how people make sense of their own lives and experiences.

Critical Analysis

This type of narrative analysis involves examining the political, social, and ideological implications of a narrative, and questioning its underlying assumptions and values. Researchers may analyze the ways in which a narrative reflects or reinforces dominant power structures, or how it challenges or subverts those structures. Critical analysis can be useful for understanding the role that narratives play in shaping social and cultural norms.

Autoethnography

This type of narrative analysis involves using personal narratives to explore cultural experiences and identity formation. Researchers may use their own personal narratives to explore issues such as race, gender, or sexuality, and to understand how larger social and cultural structures shape individual experiences. Autoethnography can be useful for understanding how individuals negotiate and navigate complex cultural identities.

Thematic Analysis

This method involves identifying themes or patterns that emerge from the data, and then interpreting these themes in relation to the research question. Researchers may use a deductive approach, where they start with a pre-existing theoretical framework, or an inductive approach, where themes are generated from the data itself.

Narrative Analysis Conducting Guide

Here are some steps for conducting narrative analysis:

• Identify the research question: Narrative analysis begins with identifying the research question or topic of interest. Researchers may want to explore a particular social or cultural phenomenon, or gain a deeper understanding of a particular individual’s experience.
• Collect the narratives: Researchers then collect the narratives or stories that they will analyze. This can involve collecting written texts, conducting interviews, or analyzing visual media.
• Transcribe and code the narratives: Once the narratives have been collected, they are transcribed into a written format, and then coded in order to identify themes, motifs, or other patterns. Researchers may use a coding scheme that has been developed specifically for the study, or they may use an existing coding scheme.
• Analyze the narratives: Researchers then analyze the narratives, focusing on the themes, motifs, and other patterns that have emerged from the coding process. They may also analyze the formal structure of the narratives, the language used, and the social and cultural context in which they are situated.
• Interpret the findings: Finally, researchers interpret the findings of the narrative analysis, and draw conclusions about the meanings, experiences, and perspectives that underlie the narratives. They may use the findings to develop theories, make recommendations, or inform further research.

Applications of Narrative Analysis

Narrative analysis is a versatile qualitative research method that has applications across a wide range of fields, including psychology, sociology, anthropology, literature, and history. Here are some examples of how narrative analysis can be used:

• Understanding individuals’ experiences: Narrative analysis can be used to gain a deeper understanding of individuals’ experiences, including their thoughts, feelings, and perspectives. For example, psychologists might use narrative analysis to explore the stories that individuals tell about their experiences with mental illness.
• Exploring cultural and social phenomena: Narrative analysis can also be used to explore cultural and social phenomena, such as gender, race, and identity. Sociologists might use narrative analysis to examine how individuals understand and experience their gender identity.
• Analyzing historical events: Narrative analysis can be used to analyze historical events, including those that have been recorded in literary texts or personal accounts. Historians might use narrative analysis to explore the stories of survivors of historical traumas, such as war or genocide.
• Examining media representations: Narrative analysis can be used to examine media representations of social and cultural phenomena, such as news stories, films, or television shows. Communication scholars might use narrative analysis to examine how news media represent different social groups.
• Developing interventions: Narrative analysis can be used to develop interventions to address social and cultural problems. For example, social workers might use narrative analysis to understand the experiences of individuals who have experienced domestic violence, and then use that knowledge to develop more effective interventions.

Examples of Narrative Analysis

Here are some examples of how narrative analysis has been used in research:

• Personal narratives of illness: Researchers have used narrative analysis to examine the personal narratives of individuals living with chronic illness, to understand how they make sense of their experiences and construct their identities.
• Oral histories: Historians have used narrative analysis to analyze oral histories to gain insights into individuals’ experiences of historical events and social movements.
• Children’s stories: Researchers have used narrative analysis to analyze children’s stories to understand how they understand and make sense of the world around them.
• Personal diaries : Researchers have used narrative analysis to examine personal diaries to gain insights into individuals’ experiences of significant life events, such as the loss of a loved one or the transition to adulthood.
• Memoirs : Researchers have used narrative analysis to analyze memoirs to understand how individuals construct their life stories and make sense of their experiences.
• Life histories : Researchers have used narrative analysis to examine life histories to gain insights into individuals’ experiences of migration, displacement, or social exclusion.

Purpose of Narrative Analysis

The purpose of narrative analysis is to gain a deeper understanding of the stories that individuals tell about their experiences, identities, and beliefs. By analyzing the structure, content, and context of these stories, researchers can uncover patterns and themes that shed light on the ways in which individuals make sense of their lives and the world around them.

The primary purpose of narrative analysis is to explore the meanings that individuals attach to their experiences. This involves examining the different elements of a story, such as the plot, characters, setting, and themes, to identify the underlying values, beliefs, and attitudes that shape the story. By analyzing these elements, researchers can gain insights into the ways in which individuals construct their identities, understand their relationships with others, and make sense of the world.

Narrative analysis can also be used to identify patterns and themes across multiple stories. This involves comparing and contrasting the stories of different individuals or groups to identify commonalities and differences. By analyzing these patterns and themes, researchers can gain insights into broader cultural and social phenomena, such as gender, race, and identity.

In addition, narrative analysis can be used to develop interventions that address social and cultural problems. By understanding the stories that individuals tell about their experiences, researchers can develop interventions that are tailored to the unique needs of different individuals and groups.

Overall, the purpose of narrative analysis is to provide a rich, nuanced understanding of the ways in which individuals construct meaning and make sense of their lives. By analyzing the stories that individuals tell, researchers can gain insights into the complex and multifaceted nature of human experience.

When to use Narrative Analysis

Here are some situations where narrative analysis may be appropriate:

• Studying life stories: Narrative analysis can be useful in understanding how individuals construct their life stories, including the events, characters, and themes that are important to them.
• Analyzing cultural narratives: Narrative analysis can be used to analyze cultural narratives, such as myths, legends, and folktales, to understand their meanings and functions.
• Exploring organizational narratives: Narrative analysis can be helpful in examining the stories that organizations tell about themselves, their histories, and their values, to understand how they shape the culture and practices of the organization.
• Investigating media narratives: Narrative analysis can be used to analyze media narratives, such as news stories, films, and TV shows, to understand how they construct meaning and influence public perceptions.
• Examining policy narratives: Narrative analysis can be helpful in examining policy narratives, such as political speeches and policy documents, to understand how they construct ideas and justify policy decisions.

Characteristics of Narrative Analysis

Here are some key characteristics of narrative analysis:

• Focus on stories and narratives: Narrative analysis is concerned with analyzing the stories and narratives that people tell, whether they are oral or written, to understand how they shape and reflect individuals’ experiences and identities.
• Emphasis on context: Narrative analysis seeks to understand the context in which the narratives are produced and the social and cultural factors that shape them.
• Interpretive approach: Narrative analysis is an interpretive approach that seeks to identify patterns and themes in the stories and narratives and to understand the meaning that individuals and communities attach to them.
• Iterative process: Narrative analysis involves an iterative process of analysis, in which the researcher continually refines their understanding of the narratives as they examine more data.
• Attention to language and form : Narrative analysis pays close attention to the language and form of the narratives, including the use of metaphor, imagery, and narrative structure, to understand the meaning that individuals and communities attach to them.
• Reflexivity : Narrative analysis requires the researcher to reflect on their own assumptions and biases and to consider how their own positionality may shape their interpretation of the narratives.
• Qualitative approach: Narrative analysis is typically a qualitative research method that involves in-depth analysis of a small number of cases rather than large-scale quantitative studies.

Advantages of Narrative Analysis

Here are some advantages of narrative analysis:

• Rich and detailed data : Narrative analysis provides rich and detailed data that allows for a deep understanding of individuals’ experiences, emotions, and identities.
• Humanizing approach: Narrative analysis allows individuals to tell their own stories and express their own perspectives, which can help to humanize research and give voice to marginalized communities.
• Holistic understanding: Narrative analysis allows researchers to understand individuals’ experiences in their entirety, including the social, cultural, and historical contexts in which they occur.
• Flexibility : Narrative analysis is a flexible research method that can be applied to a wide range of contexts and research questions.
• Interpretive insights: Narrative analysis provides interpretive insights into the meanings that individuals attach to their experiences and the ways in which they construct their identities.
• Appropriate for sensitive topics: Narrative analysis can be particularly useful in researching sensitive topics, such as trauma or mental health, as it allows individuals to express their experiences in their own words and on their own terms.
• Can lead to policy implications: Narrative analysis can provide insights that can inform policy decisions and interventions, particularly in areas such as health, education, and social policy.

Limitations of Narrative Analysis

Here are some of the limitations of narrative analysis:

• Subjectivity : Narrative analysis relies on the interpretation of researchers, which can be influenced by their own biases and assumptions.
• Limited generalizability: Narrative analysis typically involves in-depth analysis of a small number of cases, which limits its generalizability to broader populations.
• Ethical considerations: The process of eliciting and analyzing narratives can raise ethical concerns, particularly when sensitive topics such as trauma or abuse are involved.
• Limited control over data collection: Narrative analysis often relies on data that is already available, such as interviews, oral histories, or written texts, which can limit the control that researchers have over the quality and completeness of the data.
• Time-consuming: Narrative analysis can be a time-consuming research method, particularly when analyzing large amounts of data.
• Interpretation challenges: Narrative analysis requires researchers to make complex interpretations of data, which can be challenging and time-consuming.
• Limited statistical analysis: Narrative analysis is typically a qualitative research method that does not lend itself well to statistical analysis.

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Narrative Analysis 101

Everything you need to know to get started

By: Ethar Al-Saraf (PhD)| Expert Reviewed By: Eunice Rautenbach (DTech) | March 2023

If you’re new to research, the host of qualitative analysis methods available to you can be a little overwhelming. In this post, we’ll  unpack the sometimes slippery topic of narrative analysis . We’ll explain what it is, consider its strengths and weaknesses , and look at when and when not to use this analysis method. 

Overview: Narrative Analysis

• What is narrative analysis (simple definition)
• The two overarching approaches  
• The strengths & weaknesses of narrative analysis
• When (and when not) to use it
• Key takeaways

What Is Narrative Analysis?

Simply put, narrative analysis is a qualitative analysis method focused on interpreting human experiences and motivations by looking closely at the stories (the narratives) people tell in a particular context.

In other words, a narrative analysis interprets long-form participant responses or written stories as data, to uncover themes and meanings . That data could be taken from interviews, monologues, written stories, or even recordings. In other words, narrative analysis can be used on both primary and secondary data to provide evidence from the experiences described.

That’s all quite conceptual, so let’s look at an example of how narrative analysis could be used.

Let’s say you’re interested in researching the beliefs of a particular author on popular culture. In that case, you might identify the characters , plotlines , symbols and motifs used in their stories. You could then use narrative analysis to analyse these in combination and against the backdrop of the relevant context.

This would allow you to interpret the underlying meanings and implications in their writing, and what they reveal about the beliefs of the author. In other words, you’d look to understand the views of the author by analysing the narratives that run through their work.

The Two Overarching Approaches

Generally speaking, there are two approaches that one can take to narrative analysis. Specifically, an inductive approach or a deductive approach. Each one will have a meaningful impact on how you interpret your data and the conclusions you can draw, so it’s important that you understand the difference.

First up is the inductive approach to narrative analysis.

The inductive approach takes a bottom-up view , allowing the data to speak for itself, without the influence of any preconceived notions . With this approach, you begin by looking at the data and deriving patterns and themes that can be used to explain the story, as opposed to viewing the data through the lens of pre-existing hypotheses, theories or frameworks. In other words, the analysis is led by the data.

For example, with an inductive approach, you might notice patterns or themes in the way an author presents their characters or develops their plot. You’d then observe these patterns, develop an interpretation of what they might reveal in the context of the story, and draw conclusions relative to the aims of your research.

Contrasted to this is the deductive approach.

With the deductive approach to narrative analysis, you begin by using existing theories that a narrative can be tested against . Here, the analysis adopts particular theoretical assumptions and/or provides hypotheses, and then looks for evidence in a story that will either verify or disprove them.

For example, your analysis might begin with a theory that wealthy authors only tell stories to get the sympathy of their readers. A deductive analysis might then look at the narratives of wealthy authors for evidence that will substantiate (or refute) the theory and then draw conclusions about its accuracy, and suggest explanations for why that might or might not be the case.

Which approach you should take depends on your research aims, objectives and research questions . If these are more exploratory in nature, you’ll likely take an inductive approach. Conversely, if they are more confirmatory in nature, you’ll likely opt for the deductive approach.

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Strengths & Weaknesses

Now that we have a clearer view of what narrative analysis is and the two approaches to it, it’s important to understand its strengths and weaknesses , so that you can make the right choices in your research project.

A primary strength of narrative analysis is the rich insight it can generate by uncovering the underlying meanings and interpretations of human experience. The focus on an individual narrative highlights the nuances and complexities of their experience, revealing details that might be missed or considered insignificant by other methods.

Another strength of narrative analysis is the range of topics it can be used for. The focus on human experience means that a narrative analysis can democratise your data analysis, by revealing the value of individuals’ own interpretation of their experience in contrast to broader social, cultural, and political factors.

All that said, just like all analysis methods, narrative analysis has its weaknesses. It’s important to understand these so that you can choose the most appropriate method for your particular research project.

The first drawback of narrative analysis is the problem of subjectivity and interpretation . In other words, a drawback of the focus on stories and their details is that they’re open to being understood differently depending on who’s reading them. This means that a strong understanding of the author’s cultural context is crucial to developing your interpretation of the data. At the same time, it’s important that you remain open-minded in how you interpret your chosen narrative and avoid making any assumptions .

A second weakness of narrative analysis is the issue of reliability and generalisation . Since narrative analysis depends almost entirely on a subjective narrative and your interpretation, the findings and conclusions can’t usually be generalised or empirically verified. Although some conclusions can be drawn about the cultural context, they’re still based on what will almost always be anecdotal data and not suitable for the basis of a theory, for example.

Last but not least, the focus on long-form data expressed as stories means that narrative analysis can be very time-consuming . In addition to the source data itself, you will have to be well informed on the author’s cultural context as well as other interpretations of the narrative, where possible, to ensure you have a holistic view. So, if you’re going to undertake narrative analysis, make sure that you allocate a generous amount of time to work through the data.

When To Use Narrative Analysis

As a qualitative method focused on analysing and interpreting narratives describing human experiences, narrative analysis is usually most appropriate for research topics focused on social, personal, cultural , or even ideological events or phenomena and how they’re understood at an individual level.

For example, if you were interested in understanding the experiences and beliefs of individuals suffering social marginalisation, you could use narrative analysis to look at the narratives and stories told by people in marginalised groups to identify patterns , symbols , or motifs that shed light on how they rationalise their experiences.

In this example, narrative analysis presents a good natural fit as it’s focused on analysing people’s stories to understand their views and beliefs at an individual level. Conversely, if your research was geared towards understanding broader themes and patterns regarding an event or phenomena, analysis methods such as content analysis or thematic analysis may be better suited, depending on your research aim .

Let’s recap

In this post, we’ve explored the basics of narrative analysis in qualitative research. The key takeaways are:

• Narrative analysis is a qualitative analysis method focused on interpreting human experience in the form of stories or narratives .
• There are two overarching approaches to narrative analysis: the inductive (exploratory) approach and the deductive (confirmatory) approach.
• Like all analysis methods, narrative analysis has a particular set of strengths and weaknesses .
• Narrative analysis is generally most appropriate for research focused on interpreting individual, human experiences as expressed in detailed , long-form accounts.

If you’d like to learn more about narrative analysis and qualitative analysis methods in general, be sure to check out the rest of the Grad Coach blog here . Alternatively, if you’re looking for hands-on help with your project, take a look at our 1-on-1 private coaching service .

Psst… there’s more (for free)

This post is part of our dissertation mini-course, which covers everything you need to get started with your dissertation, thesis or research project. 

You Might Also Like:

Thanks. I need examples of narrative analysis

Here are some examples of research topics that could utilise narrative analysis:

Personal Narratives of Trauma: Analysing personal stories of individuals who have experienced trauma to understand the impact, coping mechanisms, and healing processes.

Identity Formation in Immigrant Communities: Examining the narratives of immigrants to explore how they construct and negotiate their identities in a new cultural context.

Media Representations of Gender: Analysing narratives in media texts (such as films, television shows, or advertisements) to investigate the portrayal of gender roles, stereotypes, and power dynamics.

Where can I find an example of a narrative analysis table ?

Please i need help with my project,

how can I cite this article in APA 7th style?

please mention the sources as well.

My research is mixed approach. I use interview,key_inforamt interview,FGD and document.so,which qualitative analysis is appropriate to analyze these data.Thanks

Which qualitative analysis methode is appropriate to analyze data obtain from intetview,key informant intetview,Focus group discussion and document.

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Methods for Conducting and Publishing Narrative Research With Undergraduates

Azriel grysman.

1 Psychology Department, Hamilton College, Clinton, NY, United States

Jennifer Lodi-Smith

2 Department of Psychological Sciences and Institute for Autism Research, Canisius College, Buffalo, NY, United States

Introduction

Narrative research systematically codes individual differences in the ways in which participants story crucial events in their lives to understand the extent to which they create meaning and purpose (McAdams, 2008 ). These narrative descriptions of life events address a diverse array of topics, such as personality (McAdams and Guo, 2015 ), development (Fivush et al., 2006 ), clinical applications (Banks and Salmon, 2013 ), well-being (Adler et al., 2016 ), gender (Grysman et al., 2016 ), and older adult memory decline (Levine et al., 2002 ).

Narrative research is an ideal way to involve undergraduate students as contributors to broader projects and often as co-authors. In narrative or mixed method research, undergraduates have the opportunity to think critically about methodology during study construction and implementation, and then by engaging with questions of construct validity when exploring how different methods yield complementary data on one topic. In narrative research in psychology, students collect data, as in many traditional psychology laboratories, but they collect either typed or spoken narratives and then extensively code narratives before quantitative data analysis can occur. Narrative research thus provides a unique opportunity to blend the psychological realities captured by qualitative data with the rigors of quantitative methods.

Narrative researchers start by establishing the construct of interest, deciding when coding narratives for this construct is the most effective form of measurement, rather than a questionnaire or some other form of assessment. A coding manual is developed or adopted, and all coders study the manual, practice implementing it, and discuss the process and any disagreements until the team is confident that all coders are implementing the rules in a similar way. A reliability set is then initiated, such that coders assess a group of narratives from the data of interest independently, compare their codes, and conduct reliability statistics (e.g., Intraclass coefficient, Cohen's kappa). When a predetermined threshold of agreement has been reached and a sufficient percentage of the narrative data has been coded, the two raters are deemed sufficiently similar, disagreements are resolved (by conversation or vote), and one coder completes the remainder of the narrative data. Readers are directed to Syed and Nelson ( 2015 ) and to Adler et al. ( 2017 ) for further details regarding this process, as these papers provide greater depth regarding best practices coding.

Narrative Coding in an Undergraduate Laboratory: Common Challenges and Best Practices

When are students co-authors.

Narrative coding requires heavy investment of time and energy from the student, but time and energy are not the only qualities that matter when deciding on authorship. Because students are often shielded from hypotheses for the duration of coding in order to maintain objectivity and to not bias them in their coding decisions, researchers may be in a bind when data finally arrive; they want to move toward writing but students are not yet sufficiently knowledgeable to act as co-authors. Kosslyn ( 2002 ) outlines six criteria for establishing authorship (see also Fine and Kurdek, 1993 ), and includes a scoring system for the idea, design, implementation (i.e., creation of materials), conducting the experiment, data analysis, and writing. A student who puts countless hours into narrative coding has still only contributed to conducting the experiment or data analysis. If the goal is including students as authors, researchers should consider these many stages as entry points into the research process. After coding has completed, students should read background literature while data are analyzed and be included in the writing process, as detailed below (see “the route to publishing”). In addition, explicit conversations with students about their roles and expectations in a project are always advised.

Roadblocks to Student Education

One concern of a researcher managing a narrative lab is communicating the goals and methods of the interrater process to student research assistants, who have likely never encountered a process like this before. Adding to this challenge is the fact that often researchers shield undergraduates from the study's hypotheses to reduce bias and maintain their objectivity, which can serve as a roadblock both for students' education and involvement in the project and for their ability to make decisions in borderline cases. Clearly communicating the goals and methods involved in a coding project are essential, as is planning for the time needed to orient students to the hypotheses after coding if they are to be included in the later steps of data analysis and writing. In the following two sections, we expand on challenges that arise in this vein and how we have addressed them.

Interpersonal Dynamics

A critical challenge in the interrater process addresses students' experience of power relationships, self-esteem, and internalization of the coding process. In the early stages, students often disagree on how to code a given narrative. Especially when the professor mediates these early disagreements, students might feel intimidated by a professor who sides with one student more consistently than another. Furthermore, disagreeing with a fellow student may be perceived as putting them down; students often hedge explanations with statements like “I was on the fence between those two,” and “you're probably right.” These interpersonal concerns must be addressed early in the coding process, with the goal of translating a theoretical construct into guidelines for making difficult decisions with idiosyncratic data. In the course of this process, students make the most progress by explaining their assumptions and decision process, to help identify points of divergence. Rules-of-thumb that are established in this process will be essential for future cases, increasing agreement but also creating a shared sense of coding goals so that it can be implemented consistently in new circumstances. Thus, interpersonal concerns and intimidation undermine the interrater process by introducing motivations for picking a particular code, ultimately creating a bias in the name of saving face and achieving agreement rather than leading toward agreement because of a shared representation of micro-level decisions that support the coding system.

Clearly communicating the goal of the interrater process is key to establishing a productive coding environment, mitigating the pitfalls described above. One of us (AG) begins coding meetings by discussing the goals of the interrater process, emphasizing that disagreeing ultimately helps us clarify assumptions and prevents future disagreements. If the professor agrees with one person more than another, it is not a sign of favoritism or greater intelligence. Given the novelty of the coding task and undergraduate students' developmental stage, students sometimes need reassurance emphasizing that some people are better at some coding systems than others, or even that some are better coders, and that these skills should not be connected to overall worth.

The next set of challenges pertains to students' own life settings. Depending on the structure of research opportunities in a given department, students work limited hours per week on a project, are commonly only available during the academic semester, and are often pulled by competing commitments. Researchers should establish a framework to help students stay focused on the coding project and complete a meaningful unit of coding before various vacations, semesters abroad, or leaving the laboratory to pursue other interests. This paper discusses best practices that help circumvent these pitfalls, but we recommend designing projects with them in mind. Some coding systems are better suited to semester-long commitments of 3 h per week whereas others need larger time commitments, such as from students completing summer research. It is helpful to identify RAs' long-term plans across semesters, knowing who is going abroad, who expects to stay in the lab, and assigning projects accordingly.

Building a robust collaborative environment can shape an invested team who will be engaged in the sustained efforts needed for successful narrative research. In one of our labs (JLS), general lab meetings are conducted to discuss coding protocols and do collaborative practice. Then an experienced coder is paired with a new lab member. The experienced coder codes while walking the new coder through the decision process for a week's worth of assigned coding. The new coder practices on a standard set of practice narratives under the supervision of the experienced coder, discussing the process throughout. The new coder's work is checked for agreement with published codes and years of other practice coders. The new coder then codes new narratives under the supervision of the experienced coder for 2 weeks or until comfortable coding independently. The most experienced and conscientious junior applies for an internal grant each year to be the lab manager during senior year. This lab manager assigns weekly coding and assists with practical concerns. Coding challenges are discussed at weekly lab meetings. More experienced coders also lead weekly “discrepancy meetings” where two or three trained coders review discrepancies in a coded data set and come to a consensus rating. Such meetings give the students further learning and leadership opportunities. These meetings are done in small teams to accommodate the students' differing schedules and help build understanding of the constructs and a good dynamic in the team.

The Route to Publishing With Undergraduates in Narrative Psychology

When coding has successfully been completed, researchers then have the opportunity to publish their work with undergraduates. When talented students are involved on projects, the transition to writing completes their research experience. A timeline should be established and a process clearly identified: who is the lead author? Is that person writing the whole manuscript and the second author editing or are different sections being written? We have considered all these approaches depending on the abilities and circumstances of the undergraduate. In one example Grysman and Denney ( 2017 ), AG sent successive sections to the student for editing throughout the writing process. In another, because of the student's ability in quantitative analysis and figure creation (Grysman and Dimakis, 2018 ), the undergraduate took the lead on results, and edited the researcher's writing for the introduction and discussion. In a third (Meisels and Grysman, submitted), the undergraduate more centrally designed the study as an honors thesis, and is writing up the manuscript while the researcher edits and writes the heavier statistics and methodological pieces. In another example, Lodi-Smith et al. ( 2009 ) archival open-ended responses were available to code for new constructs, allowing for a shorter project time frame than collecting new narrative data. The undergraduate student's three-semester honors thesis provided the time, scope, and opportunity to code and analyze archival narratives of personality change during college. As narrative labs often have a rich pool of archival data from which new studies can emerge, they can be a rich source of novel data for undergraduate projects.

In sum, there isn't one model of how to yield publishable work, but once the core of a narrative lab has been established, the researcher can flexibly include undergraduates in the writing process to differing degrees. As in other programs of research, students have the opportunity to learn best practices in data collection and analysis in projects they are not actively coding. Because of the need to keep coders blind to study hypotheses it is often helpful to maintain multiple projects in different points of development. Students can gain experience across the research process helping collect new data, coding existing narratives, and analyzing and writing up the coding of previous cohorts of students.

Most importantly, narrative research gives students an opportunity to learn about individuals beyond what they learn in the systematic research process and outcomes of their research. The majority of undergraduate research assistants are not going on to careers as psychologists conducting academic research on narrative identity. Many undergraduate psychology students will work in clinical/counseling settings, in social work, or in related mental health fields. The skills learned in a narrative research lab can generalize far beyond the specific goals of the research team. By reading individual narratives, students and faculty have the opportunity to learn about the lived life, hearing the reality in how people story trauma, success, challenges, and change. They can begin to see subtlety and nuance beyond their own experience and come to appreciate the importance of asking questions and learning from the answers.

Author Contributions

All authors listed have made a substantial, direct and intellectual contribution to the work, and approved it for publication.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Funding. Funding for this article is supported by an internal grant from Hamilton College.

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Using narrative analysis in qualitative research

Last updated

7 March 2023

Reviewed by

Jean Kaluza

After spending considerable time and effort interviewing persons for research, you want to ensure you get the most out of the data you gathered. One method that gives you an excellent opportunity to connect with your data on a very human and personal level is a narrative analysis in qualitative research. 

Master narrative analysis

Analyze your qualitative data faster and surface more actionable insights

• What is narrative analysis?

Narrative analysis is a type of qualitative data analysis that focuses on interpreting the core narratives from a study group's personal stories. Using first-person narrative, data is acquired and organized to allow the researcher to understand how the individuals experienced something. 

Instead of focusing on just the actual words used during an interview, the narrative analysis also allows for a compilation of data on how the person expressed themselves, what language they used when describing a particular event or feeling, and the thoughts and motivations they experienced. A narrative analysis will also consider how the research participants constructed their narratives.

From the interview to coding , you should strive to keep the entire individual narrative together, so that the information shared during the interview remains intact.

Is narrative analysis qualitative or quantitative?

Narrative analysis is a qualitative research method.

Is narrative analysis a method or methodology?

A method describes the tools or processes used to understand your data; methodology describes the overall framework used to support the methods chosen. By this definition, narrative analysis can be both a method used to understand data and a methodology appropriate for approaching data that comes primarily from first-person stories.

• Do you need to perform narrative research to conduct a narrative analysis?

A narrative analysis will give the best answers about the data if you begin with conducting narrative research. Narrative research explores an entire story with a research participant to understand their personal story.

What are the characteristics of narrative research?

Narrative research always includes data from individuals that tell the story of their experiences. This is captured using loosely structured interviews . These can be a single interview or a series of long interviews over a period of time. Narrative research focuses on the construct and expressions of the story as experienced by the research participant.

• Examples of types of narratives

Narrative data is based on narratives. Your data may include the entire life story or a complete personal narrative, giving a comprehensive account of someone's life, depending on the researched subject. Alternatively, a topical story can provide context around one specific moment in the research participant's life. 

Personal narratives can be single or multiple sessions, encompassing more than topical stories but not entire life stories of the individuals.

• What is the objective of narrative analysis?

The narrative analysis seeks to organize the overall experience of a group of research participants' stories. The goal is to turn people's individual narratives into data that can be coded and organized so that researchers can easily understand the impact of a certain event, feeling, or decision on the involved persons. At the end of a narrative analysis, researchers can identify certain core narratives that capture the human experience.

What is the difference between content analysis and narrative analysis?

Content analysis is a research method that determines how often certain words, concepts, or themes appear inside a sampling of qualitative data . The narrative analysis focuses on the overall story and organizing the constructs and features of a narrative.

What is the difference between narrative analysis and case study in qualitative research?

A case study focuses on one particular event. A narrative analysis draws from a larger amount of data surrounding the entire narrative, including the thoughts that led up to a decision and the personal conclusion of the research participant. 

A case study, therefore, is any specific topic studied in depth, whereas narrative analysis explores single or multi-faceted experiences across time. ​​

What is the difference between narrative analysis and thematic analysis?

A thematic analysis will appear as researchers review the available qualitative data and note any recurring themes. Unlike narrative analysis, which describes an entire method of evaluating data to find a conclusion, a thematic analysis only describes reviewing and categorizing the data.

• Capturing narrative data

Because narrative data relies heavily on allowing a research participant to describe their experience, it is best to allow for a less structured interview. Allowing the participant to explore tangents or analyze their personal narrative will result in more complete data. 

When collecting narrative data, always allow the participant the time and space needed to complete their narrative.

• Methods of transcribing narrative data

A narrative analysis requires that the researchers have access to the entire verbatim narrative of the participant, including not just the word they use but the pauses, the verbal tics, and verbal crutches, such as "um" and "hmm." 

As the entire way the story is expressed is part of the data, a verbatim transcription should be created before attempting to code the narrative analysis.

Video and audio transcription templates

• How to code narrative analysis

Coding narrative analysis has two natural start points, either using a deductive coding system or an inductive coding system. Regardless of your chosen method, it's crucial not to lose valuable data during the organization process.

When coding, expect to see more information in the code snippets.

• Types of narrative analysis

After coding is complete, you should expect your data to look like large blocks of text organized by the parts of the story. You will also see where individual narratives compare and diverge.

Inductive method

Using an inductive narrative method treats the entire narrative as one datum or one set of information. An inductive narrative method will encourage the research participant to organize their own story. 

To make sense of how a story begins and ends, you must rely on cues from the participant. These may take the form of entrance and exit talks. 

Participants may not always provide clear indicators of where their narratives start and end. However, you can anticipate that their stories will contain elements of a beginning, middle, and end. By analyzing these components through coding, you can identify emerging patterns in the data.

Taking cues from entrance and exit talk

Entrance talk is when the participant begins a particular set of narratives. You may hear expressions such as, "I remember when…," "It first occurred to me when…," or "Here's an example…."

Exit talk allows you to see when the story is wrapping up, and you might expect to hear a phrase like, "…and that's how we decided", "after that, we moved on," or "that's pretty much it."

Deductive method

Regardless of your chosen method, using a deductive method can help preserve the overall storyline while coding. Starting with a deductive method allows for the separation of narrative pieces without compromising the story's integrity.

Hybrid inductive and deductive narrative analysis

Using both methods together gives you a comprehensive understanding of the data. You can start by coding the entire story using the inductive method. Then, you can better analyze and interpret the data by applying deductive codes to individual parts of the story.

• How to analyze data after coding using narrative analysis

A narrative analysis aims to take all relevant interviews and organize them down to a few core narratives. After reviewing the coding, these core narratives may appear through a repeated moment of decision occurring before the climax or a key feeling that affected the participant's outcome.

You may see these core narratives diverge early on, or you may learn that a particular moment after introspection reveals the core narrative for each participant. Either way, researchers can now quickly express and understand the data you acquired.

• A step-by-step approach to narrative analysis and finding core narratives

Narrative analysis may look slightly different to each research group, but we will walk through the process using the Delve method for this article.

Step 1 – Code narrative blocks

Organize your narrative blocks using inductive coding to organize stories by a life event.

Example: Narrative interviews are conducted with homeowners asking them to describe how they bought their first home.

Step 2 – Group and read by live-event

You begin your data analysis by reading through each of the narratives coded with the same life event.

Example: You read through each homeowner's experience of buying their first home and notice that some common themes begin to appear, such as "we were tired of renting," "our family expanded to the point that we needed a larger space," and "we had finally saved enough for a downpayment."

Step 3 – Create a nested story structure

As these common narratives develop throughout the participant's interviews, create and nest code according to your narrative analysis framework. Use your coding to break down the narrative into pieces that can be analyzed together.

Example: During your interviews, you find that the beginning of the narrative usually includes the pressures faced before buying a home that pushes the research participants to consider homeownership. The middle of the narrative often includes challenges that come up during the decision-making process. The end of the narrative usually includes perspectives about the excitement, stress, or consequences of home ownership that has finally taken place. 

Step 4 – Delve into the story structure

Once the narratives are organized into their pieces, you begin to notice how participants structure their own stories and where similarities and differences emerge.

Example: You find in your research that many people who choose to buy homes had the desire to buy a home before their circumstances allowed them to. You notice that almost all the stories begin with the feeling of some sort of outside pressure.

Step 5 – Compare across story structure

While breaking down narratives into smaller pieces is necessary for analysis, it's important not to lose sight of the overall story. To keep the big picture in mind, take breaks to step back and reread the entire narrative of a code block. This will help you remember how participants expressed themselves and ensure that the core narrative remains the focus of the analysis.

Example: By carefully examining the similarities across the beginnings of participants' narratives, you find the similarities in pressures. Considering the overall narrative, you notice how these pressures lead to similar decisions despite the challenges faced. 

Divergence in feelings towards homeownership can be linked to positive or negative pressures. Individuals who received positive pressure, such as family support or excitement, may view homeownership more favorably. Meanwhile, negative pressures like high rent or peer pressure may cause individuals to have a more negative attitude toward homeownership.

These factors can contribute to the initial divergence in feelings towards homeownership.

Step 6 – Tell the core narrative

After carefully analyzing the data, you have found how the narratives relate and diverge. You may be able to create a theory about why the narratives diverge and can create one or two core narratives that explain the way the story was experienced.

Example: You can now construct a core narrative on how a person's initial feelings toward buying a house affect their feelings after purchasing and living in their first home.

Narrative analysis in qualitative research is an invaluable tool to understand how people's stories and ability to self-narrate reflect the human experience. Qualitative data analysis can be improved through coding and organizing complete narratives. By doing so, researchers can conclude how humans process and move through decisions and life events.

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Principles of Social Research Methodology pp 101–115 Cite as

Narrative Inquiry, Phenomenology, and Grounded Theory in Qualitative Research

• Rabiul Islam 4 &
• Md. Sayeed Akhter 5  
• First Online: 27 October 2022

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Narrative inquiry, phenomenology, and grounded theory are the basic types of qualitative research. This chapter discusses the three major types of qualitative research—narrative inquiry, phenomenology, and grounded theory. Firstly, this chapter briefly discusses the issue of qualitative research and types. Secondly, it offers a conceptual understanding of narrative inquiry, phenomenology, and grounded theory including their basic characteristics. Finally, the chapter provides an outline of how these three types of qualitative research are applied in the field.

• Narrative inquiry
• Phenomenology
• Grounded theory
• Qualitative research

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Qualitative Research: Narrative

• Qualitative Research Texts
• Interviewing

What is Narrative Analysis?

Narrative research  is a term that subsumes a group of approaches that in turn rely on the written or spoken words or visual representation of individuals. These approaches typically focus on the lives of individuals as told through their own stories. Clandinin and Connelly define it as "a way of understanding and inquiring into experience through “collaboration between researcher and participants, over time, in a place or series of places, and in social interaction with milieus” ( Clandinin  & Connelly, 2000, p. 20)."

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Helpful Articles

• Narrative Analysis Survey of the science of Narrative Analysis by Catherine Kohler Riessman, a leading voice in the field.
• The state of the art in Narrative Inquiry Reflections on narrative inquiry and the status of the field.
• Stories of Experience and Narrative Inquiry This paper briefly surveys forms of narrative inquiry in educational studies and outline certain criteria, methods, and writing forms, which are described in terms of beginning the story, living the story, and selecting stories to construct and reconstruct narrative plots.
• Validity in Issues of Narrative Research Examines the question of validity in narrative studies.
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• Last Updated: Mar 10, 2023 2:59 PM
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What is a Qualitative Narrative Inquiry Design?

Tips for using narrative inquiry in an applied manuscript, summary of the elements of a qualitative narrative inquiry design, sampling and data collection, resource videos.

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Narrative inquiry is relatively new among the qualitative research designs compared to qualitative case study, phenomenology, ethnography, and grounded theory. What distinguishes narrative inquiry is it beings with the biographical aspect of C. Wright Mills’ trilogy of ‘biography, history, and society’(O’Tolle, 2018). The primary purpose for a narrative inquiry study is participants provide the researcher with their life experiences through thick rich stories. Narrative inquiry was first used by Connelly and Calandinin as a research design to explore the perceptions and personal stories of teachers (Connelly & Clandinin, 1990). As the seminal authors, Connelly & Clandinin (1990), posited:

Although narrative inquiry has a long intellectual history both in and out of education, it is increasingly used in studies of educational experience. One theory in educational research holds that humans are storytelling organisms who, individually and socially, lead storied lives. Thus, the study of narrative is the study of the ways humans experience the world. This general concept is refined into the view that education and educational research is the construction and reconstruction of personal and social stories; learners, teachers, and researchers are storytellers and characters in their own and other's stories. In this paper we briefly survey forms of narrative inquiry in educational studies and outline certain criteria, methods, and writing forms, which we describe in terms of beginning the story, living the story, and selecting stories to construct and reconstruct narrative plots. 

Attribution: Reprint Policy for Educational Researcher: No written or oral permission is necessary to reproduce a tale, a figure, or an excerpt fewer that 500 words from this journal, or to make photocopies for classroom use. Copyright (1990) by the American Educational Research Association; reproduced with permission from the publisher. 

• Example Qualitative Narrative Inquiry Design

First, the applied doctoral manuscript narrative inquiry researcher should recognize that they are earning a practical/professional based doctorate (Doctor of Education), rather than a research doctorate such as a Ph.D. Unlike a traditional Ph.D. dissertation oral defense where the candidates focus is on theory and research, the NU School of Education applied doctoral candidate presents their finding and contributions to practice to their doctoral committee as a conceptual professional conference level presentation that centers on how their study may resolve a complex problem or issue in the profession. When working on the applied doctoral manuscript keep the focus on the professional and practical benefits that could arise from your study. If the Applied Doctoral Experience (ADE) student is unsure as to whether the topic fits within the requirements of the applied doctoral program (and their specialization, if declared) they should reach out to their research course professor or dissertation chair for guidance. This is known as alignment to the topic and program, and is critical in producing a successful manuscript. Also, most applied doctoral students doing an educational narrative inquiry study will want to use a study site to recruit their participants. For example, the study may involve teachers or college faculty that the researcher will want to interview in order to obtain their stories. Permission may be need from not only the NU Institutional Review Board (IRB), but also the study site. For example, conducting interviews on campus, procuring private school district or college email lists, obtaining archival documents, etc. 

The popularity of narrative inquiry in education is increasing as a circular and pedagogical strategy that lends itself to the practical application of research (Kim, 2016). Keep in mind that by and large practical and professional benefits that arise from a narrative inquiry study revolve around exploring the lived experiences of educators, education administrators, students, and parents or guardians. According to Dunne (2003), 

Research into teaching is best served by narrative modes of inquiry since to understand the teacher’s practice (on his or her own part or on the part of an observer) is to find an illuminating story (or stories) to tell of what they have been involved with their student” (p. 367).

• Temporality – the time of the experiences and how the experiences could influence the future;
• Sociality – cultural and personal influences of the experiences; and;
• Spatiality – the environmental surroundings during the experiences and their influence on the experiences. 

From Haydon and van der Riet (2017)

• Narrative researchers collect stories from individuals retelling of their life experiences to a particular phenomenon. 
• Narrative stories may explore personal characteristics or identities of individuals and how they view themselves in a personal or larger context.
• Chronology is often important in narrative studies, as it allows participants to recall specific places, situations, or changes within their life history.

Sampling and Sample Size

• Purposive sampling is the most often used in narrative inquiry studies. Participants must meet a form of requirement that fits the purpose, problem, and objective of the study
• There is no rule for the sample size for narrative inquiry study. For a dissertation the normal sample size is between 6-10 participants. The reason for this is sampling should be terminated when no new information is forthcoming, which is a common strategy in qualitative studies known as sampling to the point of redundancy.

Data Collection (Methodology)

• Participant and researcher collaborate through the research process to ensure the story told and the story align.
• Extensive “time in the field” (can use Zoom) is spent with participant(s) to gather stories through multiple types of information including, field notes, observations, photos, artifacts, etc.
• Field Test is strongly recommended. The purpose of a field study is to have a panel of experts in the profession of the study review the research protocol and interview questions to ensure they align to the purpose statement and research questions.
• Member Checking is recommended. The trustworthiness of results is the bedrock of high-quality qualitative research. Member checking, also known as participant or respondent validation, is a technique for exploring the credibility of results. Data or results are returned to participants to check for accuracy and resonance with their experiences. Member checking is often mentioned as one in a list of validation techniques (Birt, et al., 2016).

Narrative Data Collection Essentials

• Restorying is the process of gathering stories, analyzing themes for key elements (e.g., time, place, plot, and environment) and then rewriting the stories to place them within a chronological sequence (Ollerenshaw & Creswell, 2002).
• Narrative thinking is critical in a narrative inquiry study. According to Kim (2016), the premise of narrative thinking comprises of three components, the storyteller’s narrative schema, his or her prior knowledge and experience, and cognitive strategies-yields a story that facilitates an understanding of the others and oneself in relation to others.

Instrumentation

• In qualitative research the researcher is the primary instrument.
• In-depth, semi-structured interviews are the norm. Because of the rigor that is required for a narrative inquiry study, it is recommended that two interviews with the same participant be conducted. The primary interview and a follow-up interview to address any additional questions that may arise from the interview transcriptions and/or member checking.

Birt, L., Scott, S., Cavers, D., Campbell, C., & Walter, F. (2016). Member checking: A tool to enhance trustworthiness or merely a nod to validation? Qualitative Health Research, 26 (13), 1802-1811. http://dx.doi.org./10.1177/1049732316654870

Cline, J. M. (2020). Collaborative learning for students with learning disabilities in inclusive classrooms: A qualitative narrative inquiry study (Order No. 28263106). Available from ProQuest Dissertations & Theses Global. (2503473076). 

Connelly, F. M., & Clandinin, D. J. (1990). Stories of Experience and Narrative Inquiry. Educational Researcher, 19 (5), 2–14. https://doi.org/10.1080/03323315.2018.1465839

Dunne, J. (2003). Arguing for teaching as a practice: A reply to Alasdair Macintyre. Journal of Philosophy of Education . https://doi.org/10.1111/1467-9752.00331 

Haydon, G., & der Riet, P. van. (2017). Narrative inquiry: A relational research methodology suitable to explore narratives of health and illness. Nordic Journal of Nursing Research , 37(2), 85–89. https://doi.org/10.1177/2057158516675217

Kim, J. H. (2016). Understanding Narrative Inquiry: The crafting and analysis of stories as research. Sage Publications. 

Kim J. H. (2017). Jeong-Hee Kim discusses narrative methods [Video]. SAGE Research Methods Video https://www-doi-org.proxy1.ncu.edu/10.4135/9781473985179

O’ Toole, J. (2018). Institutional storytelling and personal narratives: reflecting on the value of narrative inquiry. Institutional Educational Studies, 37 (2), 175-189. https://doi.org/10.1080/03323315.2018.1465839

Ollerenshaw, J. A., & Creswell, J. W. (2002). Narrative research: A comparison of two restorying data analysis approaches. Qualitative Inquiry, 8 (3), 329–347. 

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• Open access
• Published: 01 April 2024

Midwives’ lived experiences of caring for women with mobility disabilities during pregnancy, labour and puerperium in Eswatini: a qualitative study

• Annie M. Temane 1 ,
• Fortunate N. Magagula 2 &
• Anna G. W. Nolte 1  

BMC Women's Health volume  24 , Article number:  207 ( 2024 ) Cite this article

Metrics details

Midwives encounter various difficulties while aiming to achieve excellence in providing maternity care to women with mobility disabilities. The study aimed to explore and describe midwives’ experiences of caring for women with mobility disabilities during pregnancy, labour and puerperium in Eswatini.

A qualitative, exploratory, descriptive, contextual research design with a phenomenological approach was followed. Twelve midwives working in maternal health facilities in the Hhohho and Manzini regions in Eswatini were interviewed. Purposive sampling was used to select midwives to participate in the research. In-depth phenomenological interviews were conducted, and Giorgi’s descriptive phenomenological method was used for data analysis.

Three themes emerged from the data analysis: midwives experienced physical and emotional strain in providing maternity care to women with mobility disabilities, they experienced frustration due to the lack of equipment to meet the needs of women with mobility disabilities, and they faced challenges in providing support and holistic care to women with mobility disabilities during pregnancy, labour and puerperium.

Conclusions

Midwives experienced challenges caring for women with mobility disabilities during pregnancy, labour and the puerperium in Eswatini. There is a need to develop and empower midwives with the knowledge and skill to implement guidelines and enact protocols. Moreover, equipment and infrastructure are required to facilitate support and holistic maternity care for women with mobility disabilities.

Peer Review reports

Globally, few studies have focused on midwives’ views of providing maternity care to women with mobility disabilities during pregnancy, labour and the puerperium [ 1 ]. In The Disabled World [ 2 ], the World Health Organisation (WHO) defines ‘disability’ as an umbrella term covering impairments, activity limitations, and participation restrictions. Furthermore, the WHO defines an ‘impairment’ as a problem in bodily function or structure; an ‘activity limitation’ as a difficulty encountered by an individual in executing a task or action; and ‘participation restriction’ as a problem experienced by an individual in various life situations [ 2 ]. In this study, mobility disabilities refer to an impairment in the functioning of the upper and lower extremities as experienced by women during pregnancy, labour and the puerperium.

Midwives, as frontline workers in the delivery of maternity care [ 3 ] responsible for the lives of the mother and the baby, are accountable for providing competent and holistic care for women during pregnancy, labour and puerperium. As part of healthcare provision, midwives play an important role in ensuring that every woman, including women with mobility disabilities, receives the best maternity care during pregnancy, labour and puerperium. Moridi et al. [ 4 ] state that women with mobility disabilities are entitled to feel safe, respected and well cared for by midwives, who must be sufficiently prepared to care for these women.

According to the Global Population Report, [ 5 ] more than one billion people have some form of disability. Eswatini is classified as a middle-income setting in the southern African region, measuring 17 000 square kilometres with a population of 1 093 238. Of the population, 76.2% reside in rural areas (833 472), and 23.8% (259 766) reside in urban areas [ 6 ]. The economy is largely agricultural as most industries manufacture agricultural products [ 7 ]. Of the Eswatini population, 146 554 (13%) live with disabilities, with most being women (87 258; 16%), 22,871 (14.1%) and 26,270 (14.3%) of them reside in the Hhohho and Manzini regions respectively [ 8 ]. 15% (125 545) of people with disabilities live in rural areas, and 85% of the disabled population is unemployed [ 8 ], which means most of these individuals are economically disadvantaged. Furthermore, according to the Eswatini Central Statistics Office, 8 26.5% of people with disabilities have a mobility (walking) disability, with 63.5% of these being women.

Midwives may encounter difficulties while aiming to achieve excellence in providing maternity care to women with mobility disabilities in what may be challenging circumstances [ 9 ]. The WHO [ 10 ] claims people with disabilities do not receive the health services they need and are thus likely to find healthcare providers have inadequate skills. Lawler et al. [ 11 ] argue that ineffective interactions and poor communication with women needing care, particularly among health professionals engaged in providing maternity services, limit these women’s opportunities to participate in decision-making processes during pregnancy, childbirth, and postpartum care. According to the University of Johannesburg, [ 12 ] the midwife, together with the mother, have to engage collaboratively in order to come up with opportunities to promote health while removing any challenges that could impede the achievement thereof.

Walsh-Gallagher et al. [ 13 ] postulate that healthcare professionals tend to view women with disabilities as liabilities and regard them as high risk; they often exclude them from the individualised plan of care, which leads to an increase in these women’s fears about their maternity care. These challenges frequently result in health disparities and prevent women with mobility disabilities from receiving optimal maternity care. By exploring midwives’ experiences of this phenomenon, guidelines for support can be developed to extend available knowledge on maternity care for women with mobility disabilities during pregnancy, labour and puerperium.

Study design

The aim of the study was to explore and describe midwives’ experiences of caring for women with mobility disabilities during pregnancy, labour and puerperium in the Hhohho and Manzini regions of Eswatini. A qualitative, [ 14 ] exploratory, [ 15 ] descriptive, [ 16 ] contextual [ 17 ] research design with a phenomenological approach [ 18 ] was applied for this study to gain insight and understanding of the research phenomenon [ 19 ]. The phenomenon under study was midwives’ lived experiences caring for women with mobility disabilities during pregnancy, labour and puerperium. The participants were approached face-to-face to participate in the study. The researchers followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) to report on this qualitative study [ 20 ].

The setting for the study was the Hhohho and Manzini regions of Eswatini. The researcher collected data at the site where participants experienced the phenomenon, as emphasised by Yildiz, [ 21 ] within the context in which they were comfortable to be interviewed [ 22 ]. This setting included maternal health facilities in hospitals and public health units.

Population and sampling

The study’s population comprised midwives working in maternal health facilities in hospitals and public health units, that is, one referral hospital and one public health unit in the Hhohho region and two referral hospitals and one public health unit in the Manzini region of Eswatini. Purposive sampling was used to select midwives to participate in the study; [ 16 ] 12 midwives from both regions were included. The midwives were between the ages of 35 and 55, and all midwives were black in race and identified as females. The years of experience in the field ranged between 5 and 15 years. The criteria for inclusion were midwives who had provided maternity care to women with mobility disabilities during pregnancy, labour and puerperium for a period of not more than two to three years, willing to participate in the study. The sample size was determined by repetitions of key statements about the research phenomenon during data collection, termed data saturation [ 23 ]. None of the participants refused to participate in the study.

Table  1 summarises the participants’ demographic characteristics.

Data collection

In-depth phenomenological, face-to-face, individual interviews were conducted to collect data [ 17 ]. The researcher who was a Midwifery lecturer held a Master’s Degree in Maternal and Neonatal science at the time of the study requested approval from the Unit manager to seek permission from the midwives to take part in the study. The midwives were given an information letter which included objectives of the study and the reasons for conducting the study. After recruiting midwives and obtaining their written consent to participate in the study and permission to audio-record the interviews, the researcher set up appointments with them for the interviews, and the data collection process commenced. The central question posed to participants was: How was it for you to care for a woman with a mobility disability during pregnancy, labour and puerperium? A pilot of the tool was performed on the first participant who met the inclusion criteria and possessed the same characteristics as those of the study sample. The pre-testing question yielded positive results, the participant responded to the question asked and there was no need to rephrase it or further test it.

The interviews were conducted from March 2019 to July 2019 and lasted 30–45 min. The researcher conducted interviews until the data became redundant and repetitive, reflecting that saturation had been reached, in congruence with Fouché et al. [ 25 ] In addition, field notes were recorded in a notebook after each in-depth phenomenological interview. No repeat interviews were held. The researcher ensured bracketing by omitting any perceptions from her past experiences that were likely to influence her interpretation of the research findings.

Data analysis

Before data analysis commenced, data were organised in computer files after being transcribed and translated into narrative form. Data from each participant were coded and stored in the relevant file and kept in a safe place; only the researcher could access the information. Back-up copies were made of all the data, and the master copies were stored in a safe to which only the researcher had access.

Data collection and analysis occurred concurrently. The researcher was guided by Giorgi et al.’s [ 26 ] five-step method of data analysis. This entailed the researcher reading all the transcribed data and the entire ‘naïve description’ provided by the participants during the interviews. The demarcation of ‘meaning units’ within narratives followed. In addition, the researcher marked where meaning shifts occurred and transformed meaning units into descriptive expressions. The researcher laid out the general structure of midwives’ experiences. Moreover, an independent coder was provided with the raw data (after signing a confidentiality agreement) to analyse the findings. The researcher and independent coder analysed the data separately and met for a consensus discussion. Both agreed on all the units of analysis, with an inter-coder reliability of 100%.

Measures of trustworthiness

The research was informed by Guba and Lincoln’s [ 27 ] model in relation to credibility, transferability, dependability and confirmability. For credibility, the researcher ensured prolonged engagement in the field [ 28 ], peer debriefing, [ 29 ] member checking, and an external auditor was used [ 25 ]. The study was also presented at a national conference. Transferability refers to the ability to extend the findings of one’s study to comparable environments or participants, as stated by Pitney et al. [ 30 ] The researcher ensured the study’s transferability by providing a richly documented account and in-depth description of all aspects and processes of the study protocol. Data saturation also confirmed transferability [ 23 ]. Dependability is evident in a study when other researchers are able to follow the researcher’s decision trail [ 31 ]. The researcher ensured dependability by densely describing the research process in congruence with Fouché et al.’s [ 25 ] guidelines, so that other researchers can follow similar steps of the same research methodology. Confirmability occurs when the research is judged by the way in which the findings and conclusions achieve their aim and are not the result of the researcher’s prior assumptions and preconceptions [ 32 ]. The researcher ensured this by remaining true to the research process through reflexivity and not compromising the research process in any way [ 28 ]. In addition, the researcher engaged an independent coder and provided a chain of evidence of the entire research process to enable an audit. Therefore, all forms of collected data, including raw data, reflexive journals, [ 29 ] notes and transcriptions, were recorded.

Ethical clearance to conduct this study was obtained from the University of Johannesburg Faculty of Health Sciences Higher Degrees Committee (ref. no. HDC-01-50-2018), University of Johannesburg Faculty of Health Research Ethics Committee (ref. no. REC-01-82-2018), and the Eswatini National Health Research Review Board (ref. no. NHRRB982/2018). The researcher applied and adhered to the four principles to be considered when conducting research: autonomy, beneficence, non-maleficence and justice [ 33 ]. Autonomy was adhered to by affording the participants the right to choose to participate in the study and by signing a written informed consent form a week after it was given to them before the interviews commenced. Beneficence was ensured through doing good and doing no harm to participants by prioritising the participants’ interests above those of the researcher, and did not engage in any practice that jeopardised their rights. Non-maleficence was observed by eradicating any possible harmful risks in the study; the researcher ensured the safety of the participants by conducting interviews in a familiar, private environment where they felt free and safe from harm. Furthermore, justice was observed by treating all participants equally regardless of their biographical, social and economic status.

Three themes and categories emerged from the data analysis. Table  2 summarises the themes and categories of midwives’ lived experiences caring for women with mobility disabilities during pregnancy, labour and puerperium in Eswatini.

Theme 1: physical and emotional efforts required from midwives to provide maternity care to women with mobility disabilities

Category 1.1: midwives experienced that woman with mobility disabilities needed assistance getting onto the bed during labour and delivery.

According to the participants, caring for women with mobility disabilities weighed heavily on them physically as they were required to assist the women onto delivery beds, which were too high for the women to climb up on their own:

“The beds are too high, they need to be adjustable…unless you change her to another room, we only have one in the other room…but to be honest she delivered on the same high bed with the help…It’s uncomfortable even with me who is normal, how about someone who has a disability? Getting the woman onto the bed is also uncomfortable for us we end up having pain on our backs.” (M3) . “The challenge is that I couldn’t help her to climb on to the bed, because I needed someone to assist when she came for postnatal care as she was even carrying 3 babies, I didn’t know what to do…I eventually went out and asked for assistance from my colleague…” (M10) . “I believe that the equipment should accommodate the women with disability, however, ours is not accommodative to the women…there are no special delivery beds, specifically designed for them because in my opinion the beds have to be shorter so they can be able to get on to them easily…yes so that they can be able to climb on the beds” (M1) .

Category 1.2: midwives experienced challenges in manoeuvring women with mobility disabilities during labour

Midwives reported it was difficult to perform some procedures while progressing these women during labour and delivery. This situation called for some adjustment and improvisation on their part, and they were unsure if it was the right thing to do.

“Even though she was a bit uncomfortable and anxious because the leg was just straight and could not bend, I reassured her…She had to remove the artificial leg and remain with the stump. I placed her on the lithotomy position. With the other hand she had to hold on to the ankle of the normal foot, even though it was awkward and difficult to manoeuvre, she managed to deliver the baby.” (M1) . “Luckily for us, she didn’t sustain a tear and we were saved from suturing her cause we foresaw difficulties as how we could have done it as she couldn’t open her thighs well due to the disability…yes I had to get a partner to assist, since she couldn’t even open her thighs. She also couldn’t cooperate possibly because of the pain that is also more reason I asked for my colleague to assist.” (M6) . “…yes…let me make an example, in my case she had a fracture, even if the pelvis was gynaecoid, there were problems of finding the right position for her during delivery, when she had to push the baby out…” (M8) . “The one that I saw did not have one leg. She had come for her postnatal care. We assisted and her on the couch, with my colleague. Since she couldn’t keep her legs open, I asked my colleague to keep one of her legs open whilst I examined her.” (M12) .

Category 1.3: midwives experienced anxiety and the need to exercise patience when caring for women with mobility disabilities

The participants experienced an emotional and psychological burden when caring for women with mobility disabilities. They felt unqualified and foresaw difficulties that triggered anxiety, which led to them not knowing what to do and how to handle these women.

“It was during labour…the woman was limping the woman she was on crutches. The moment she came into the ward I am a human being I just felt sorry for her kutsi (as to) how is she going to take care of the baby, and the hand was somehow deformed.” (M3) . “At first its emotionally draining as an individual you cause you start sympathising…(other midwife chips in)…yes you even find yourself saying things just because you pity her, and in the process they get hurt.” (M6) . “It came as a shock and it was my first experience, it came as a shock as to how I was going to help her as even my experience was limited in that area.” (M7) . “As I was taking care of her it became necessary for me to put myself into her shoes and to bear with her considering her situation….When you see her for the first time you would pity her yet she is now used to it.” (M1) .

Theme 2: lack of equipment to meet the needs of women with mobility disabilities

Category 2.1: midwives reported a lack of special beds and infrastructure to meet the needs of women with mobility disabilities.

Midwives reported their frustration at the lack of sufficient equipment like special beds and examination tables, tailored for women with mobility disabilities. It was a challenge to provide maternity care for women without this equipment.

“I believe that the infrastructure and equipment should accommodate the women with mobility disability, however, ours is not accommodative to the women…Usually we don’t have the prenatal ward in the maternity, most women who come in the latent phase have to ambulate, or go to the waiting huts and come back when the labour pains are stronger…There are no special delivery beds, specifically designed for them because in my opinion the beds have to be shorter so they can be able to get on to them easily. We do not even have toilets meant for them.” (M1) . “I was anxious as to how was she going to push how to push cause we do not have the right beds when it was time for pushing I asked for assistance…” (M2) . “The challenge is that I couldn’t help her to climb on to the bed, because I needed someone to assist when she came for postnatal care…the beds need to be adjustable so that they are able to be pushed lower for the mother to move from wheel chair to the bed and we pull the bed up again to examine her.” (M11) .

Theme 3: challenges in providing holistic care to women with mobility disabilities during pregnancy, labour, and puerperium

Category 3.1: midwives reported a lack of guidelines and protocols in caring holistically for women with mobility disabilities.

Midwives emphasised a lack of guidelines, protocols and knowledge about caring holistically for women with mobility disabilities. This resulted in everyone making their own decisions and doing as they saw fit in caring for these women:

“I think during antenatal care they (the women with mobility disabilities) need to be prepared for labour cause for others the pain is extraordinary, apart from the pain threshold, they also face self-esteem issues, they are looked down upon…I only saw that she was disabled during assessment cause nothing was recorded on the antenatal care card.” (M2) . “I was not aware of the disability at first, I only discovered when she was pushing…she was admitted and progressed by another midwife, I only attended to her when she was pushing… there was nothing written on the nurse’s notes/ handover notes about her disability.” (M5) . “There is no normal practice for a woman with mobility disability when they come and they are in labour, I usually admit regardless of the stage of labour or dilatation…It is not a protocol, it’s a midwife’s prerogative.” (M1) . “We assess and come up with our own discretion even in terms of admitting them (women with mobility disability). Some midwives will admit them regardless of the stage of labour and disregard the protocol that women who come into labour have to ambulate if they are in the latent phase.” (M8) . “There is one that came the past 3 days she has 3 children now and we just scheduled her for c/section because we know that she has been having c/section since she started. Just from looking at the way she walked, we could tell that she couldn’t deliver normally.” (M9) .

Category 3.2: midwives experienced challenges in allowing significant others to support women with mobility disabilities during labour and delivery

Consequent to the challenges in providing holistic care to women with mobility disabilities, midwives experienced challenges in allowing significant others to support these women during labour and delivery.

“It can depend on the patients themselves, they should decide and we need to be flexible for it to happen…as you can see our labour room also has the issue of privacy…we would need to restructure cause we have beds for 5 or more women in labour room…and then bringing someone from outside could be tricky” (M6) . “Maybe…not sure though, that they can bring their relatives, but maybe, considering staffing limitation…also the issue of discrimination and privacy, they (the women with disabilities) might feel we discriminate against them because they are disabled we now treat them differently.” (M7) . “Maybe if she can (bring her relative) but that’s not necessary, because I can always ask my colleague to assist, unless there is no one…” (M12) .

Childbirth is a special experience that requires a personal connection between the midwife and the woman giving birth, characterised by successful communication and respect [ 34 ]. However, the themes identified in the study indicated that midwives experienced challenges caring for women with mobility disabilities during pregnancy, labour and puerperium based on their limited capacity and preparedness, and lack of protocols to care for these women. They also reported a lack of supportive equipment for women with mobility disabilities. This posed a challenge for them in attending to these women’s specific needs, and they did not always know how to handle the situation appropriately.

One of the themes centred on midwives’ experiences of the physical and emotional efforts required of them to provide maternity care to women with mobility disabilities. They explained women with mobility disabilities required assistance getting onto the bed during labour and delivery, and more manoeuvring was expected of them (as midwives) as they had to adjust their performance and some procedures. The midwives also reported challenges in providing holistic care to women with mobility disabilities during pregnancy, labour and puerperium. Konig-Bachmann et al. [ 35 ] reiterate that caring for women with disabilities requires a level of flexibility, adaptation beyond routine procedures, and demands a high degree of improvisation from healthcare providers to ensure high-quality care. Morrison et al. [ 36 ] also found that healthcare providers reported difficulties with equipment when providing healthcare for women with physical disabilities; particularly the beds being too high for them to access. Smeltzer et al. [ 37 ] similarly allude to the importance of educating and training clinicians to equip them with knowledge and technical skills to provide more effective care to women with physical disabilities.

The midwives also shared that labour and deliveries were further complicated by some women with mobility disabilities not being able to cooperate due to the pain they experienced; others could not change position due to their disability. In a study by Sonalkar et al., [ 38 ] healthcare providers described the gynaecologic examination as challenging to complete as it required patience and the ability to be adaptable to different methods and positioning. Similarly, Konig-Bachmann et al. [ 35 ] indicate that in order to provide high-quality care for women with disabilities, healthcare providers need to exercise strong flexibility, adapt beyond routine procedures, and engage in a high degree of improvisation. Byrnes and Hickey [ 39 ] concur with this study’s findings and state that due to mobility restrictions, it may be difficult to assess the fundal height and foetal growth in women with physical disabilities.

Some midwives reported their caregiving role was emotionally draining as they felt sorry and pitied the women with mobility disabilities; thus, they needed to show compassion and reassure them. According to Mgwili et al., [ 40 ] psychoanalytic thinkers associate pity among staff members upon first contact with a physically disabled person as being instigated by personal feelings, stimulated by the disability. The midwives in this study stated they needed to be more patient and adjust their approach to caring for these women. Tarasoff [ 41 ] and Schildberger et al. [ 42 ] reiterated that healthcare providers seemed uncomfortable with women’s disability, consequently failing to offer needed support. According to Sonalkar et al., [ 38 ] healthcare providers reported there would be less fear and concern about hurting women with disabilities if midwives had increased training. Similarly, Mitra et al. [ 43 ] mentioned that healthcare providers had a general lack of confidence in their ability to provide adequate maternity care for women with physical disabilities.

Another theme was midwives’ challenges in providing competent and quality care for women with mobility disabilities due to a lack of equipment, including special beds and examination tables to meet these women’s needs. The examination, labour and delivery beds were too high and could not be adjusted for the women to get on by themselves, or even with the assistance of a midwife. In addition, the midwives reported there was no prenatal ward or waiting huts where they could place these women during the latent phase of labour. The midwives further emphasised there were no special toilets for women with mobility disabilities, which made it hazardous and difficult for them. Mitra et al. [ 43 ] concur on the barriers to providing maternity care to women with physical disabilities presented from health professionals’ perspectives. The authors indicated that participants from their study reported inaccessible equipment, including examination tables, as a barrier, making it more difficult and time-consuming to care for women with physical disabilities. In addition, Sonalkar et al. [ 38 ] said healthcare providers shared their concern about the lack of adjustable examination tables and transfer equipment, thus presenting a barrier to equitable care for women with disabilities.

Midwives further reported a lack of guidelines and protocols. This resulted in everyone making their own decisions and doing as they saw fit in caring for these women, and, in most instances, not recording the disability at all during antenatal care and admission into labour records. They often only discovered that the woman had a mobility disability at a later stage, when they were in labour. Sonalkar et al. [ 38 ] reported that healthcare providers felt frustrated and overwhelmed by the uncertainty of whether they made the correct decisions when caring for women with physical disabilities due to the lack of guidelines forcing them to use their own judgement. Mitra et al. [ 43 ] determined that most healthcare providers reported a lack of maternity practice guidelines for women with physical disabilities. Also, healthcare providers highlighted the importance of learning about disabilities and having a better understanding of a condition, particularly if it is likely to be exacerbated during pregnancy [ 44 ]. The need to make and read the notes on these women’s antenatal care cards or reports was emphasised.

Due to the lack of clear guidelines and protocols in caring for women with mobility disabilities, the midwives reported they sometimes admitted the woman into the labour ward regardless of the stage of labour, while other midwives did not and wanted them to walk around and come back for admission once they are in the active phase of labour. Furthermore, the midwives explained they often referred these women for caesarean sections right away, regardless of whether the woman could deliver normally due to mere panic from just seeing the disability or based on a previous record of surgery. Smeltzer et al. [ 45 ] researched obstetric clinicians’ experiences and educational preparation in caring for pregnant women with physical disabilities, and they agree on the lack of knowledge among health professionals caring for women with mobility disability.

Devkota et al. [ 46 ] also agree regarding midwives’ inefficiency in providing quality care for women with mobility disabilities. They claim healthcare providers often struggle to understand women with disabilities’ needs as they are not formally trained to provide services to this population. These healthcare providers were found to be undertrained in specific skills that would equip them to provide better and more targeted services for women with disabilities.

Consequent to the challenges in providing holistic care to women with mobility disabilities during pregnancy, labour and puerperium, midwives experienced challenges in allowing significant others to support these women. They reported that as much as they needed assistance caring for these women, and as much as the women would prefer to have their family members or significant others assisting them, this is not possible due to the lack of privacy, especially in public health facilities. Walsh-Gallager et al.’s [ 13 ] study on the ambiguity of disabled women’s experiences of pregnancy, childbirth and motherhood resonate with this study’s findings. The authors reported that women with disabilities’ partners were denied access or had their visits curtailed on several occasions due to inflexible hospital visiting policies. Redshaw et al. [ 47 ] reiterated the same in their study; disabled women were less likely to say their companion or partner was welcome to visit, let alone provide any form of assistance. In addition, a study by Bassoumah and Mohammad [ 48 ] reported that women with disabilities were denied their spouses’ support while receiving maternity care. Byrnes and Hickey [ 39 ] also concur that every effort should be made to allow women with disabilities who are in labour to receive support from significant others, and they should be active partners in the labour process.

Limitations

The study was limited to two of the four regions of Eswatini, namely Hhohho and Manzini; hence, the results could not be generalised for the whole country. The study also only focused on mobility disabilities due to time constraints and limited funds. Future research could be conducted to cover all other forms of disabilities.

This study focused on midwives’ lived experiences caring for women with mobility disabilities during pregnancy, labour and puerperium in Eswatini. In-depth phenomenological interviews were conducted, the findings were analysed, and themes were established. The findings illustrate that midwives experienced challenges caring for women with mobility disabilities during pregnancy, labour and puerperium in Eswatini. There is a need to develop and implement guidelines to empower midwives with knowledge and skill to provide support and holistic maternity care, and enact protocols. They should also have access to appropriate equipment and infrastructure specifically tailored towards promoting optimal health for women with mobility disabilities.

Data availability

The data analysed is available from the corresponding author upon reasonable request.

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Acknowledgements

The authors would like to acknowledge the midwives in the Hhohho and Manzini regions of Eswatini who participated in the study and provided their own experiences of providing maternity care to women with mobility disabilities during pregnancy, labour and puerperium.

The research received funding from the University of Johannesburg Postgraduate Supervisor-linked Bursary.

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Annie M. Temane & Anna G. W. Nolte

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F.N.M conducted the research and wrote the manuscript. A.M.T supervised, reviewed, and finalised the manuscript. A.G.W.N co-supervised the study and edited the manuscript for final submission.

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Ethical clearance to conduct this study was obtained from the University of Johannesburg Faculty of Health Sciences Higher Degrees Committee (ref. no. HDC-01-50-2018), University of Johannesburg Faculty of Health Research Ethics Committee (ref. no. REC-01-82-2018) and the Eswatini National Health Research Review Board (ref. no. NHRRB982/2018). Participation in this study was voluntary, and informed consent was obtained from participants before the interviews commenced.

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Temane, A.M., Magagula, F.N. & Nolte, A.G.W. Midwives’ lived experiences of caring for women with mobility disabilities during pregnancy, labour and puerperium in Eswatini: a qualitative study. BMC Women's Health 24 , 207 (2024). https://doi.org/10.1186/s12905-024-03032-z

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Received : 18 August 2023

Accepted : 18 March 2024

Published : 01 April 2024

DOI : https://doi.org/10.1186/s12905-024-03032-z

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