Dear Dr. Mphande,

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Kind regards,

Sunita Panda, PhD

Academic Editor

PLOS ONE

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Additional Editor Comments

Thank you for submitting your manuscript. Both reviewers have provided detailed feedback and have suggested revisions. Therefore, I invite you to respond to the reviewers' comments and submit your revised manuscript.

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

Reviewer #1: Yes

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously? -->?>

Reviewer #1: N/A

Reviewer #2: No

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3. Have the authors made all data underlying the findings in their manuscript fully available??>

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.-->

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: The authors are to be commended for this study which addresses the experiences of women experiencing emergency caesarean birth.

Well done on using terminology for caesarian birth but there is inconsistency in the text where caesarean delivery is used in some situations. Best to be consistent or else explain why different terms are used.

Table 1 could be presented in a format that is easier to read i.e. number of first time mother, age groups, education level etc.

Did all participants have the same level of care, just wondered if some had private health care and if that was reflected in the interviews?

L 244 Fasting a better term to use than starving

Reviewer #2: Dear Author

consider the following ponts for improvement.

Abstract:

- can add important details, eg. design- phenomenological qualitative design, inductive thematic analysis...etc

- Specify key themes in results can added...

Introduction:

- Add about key global issues e.g.,

- Communication failures contribute to obstetric violence, mistrust, and PTSD...etc

- need of the study or knowledge gap to be added to justify the need of the study.

Material and methods:

- add: justification- how 30 participants were selected, how the data saturation was decided, add more details about how the thematic saturation was decided.

Line 115- add more details about how the thematic saturation was decided,

- Who conducted the interview?

- The interview was though with local language, what was the local language?

Linr 141- INVIVO-version?

Line 153- not clear... incomplete sentence..

Results:

- Present themes and sub-themes more systematically (e.g., thematic headings with clear structure).

- Under each theme, briefly summarize the key idea before providing quotes.

- Table 1 needs improved formatting.

- can add a summary table of themes.

Discussion:

- Add about what this study adds -a paragraph.

- Discuss potential systemic reasons behind poor communication (workload, staff shortages, power dynamics).

- Link results to respectful maternity care frameworks.

Strengths and limitations:

- Mention potential social desirability bias due to hospital setting.

- Clarify interviews were conducted by a non-clinician as a strength.

Conclusion:

- Write conclusions based on practical implications.

Others:

- Use Standardise terms: caesarean birth, caesarean delivery, and C-section.

- Over all Grammatical corrections:

Eg: This study novel provides insights… - This study provides novel insights…

- Summaries their demographic characteristics - summarises

- Need to edit small spacing/line break issues throughout the manuscript.

Note: in attachments, interview guide for medical practionners and codes are attached, but nothing related was mentioned in manuscript?

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what does this mean?). If published, this will include your full peer review and any attached files.). If published, this will include your full peer review and any attached files.). If published, this will include your full peer review and any attached files.). If published, this will include your full peer review and any attached files.

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Reviewer #1: Yes: Rhona O'ConnellRhona O'ConnellRhona O'ConnellRhona O'Connell

Reviewer #2: No

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Attachments

Attachment

Submitted filename: PONE-D-25-47624Pj.pdf

Women’s experiences of communication with medical staff before and after emergency caesarean birth in Zambia: a qualitative study.

PONE-D-25-47624R1

Dear Dr. Mphande,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Sunita Panda, PhD

Academic Editor

PLOS One

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #1: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions??>

Reviewer #1: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously? -->?>

Reviewer #1: N/A

**********

4. Have the authors made all data underlying the findings in their manuscript fully available??>

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.-->

Reviewer #1: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #1: Yes

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Reviewer #1: This manuscript is now acceptable for publication, all suggested edits have been addressed. I hope that communication for health care professionals will improve once the findings from this study are disseminated.

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what does this mean?). If published, this will include your full peer review and any attached files.). If published, this will include your full peer review and any attached files.). If published, this will include your full peer review and any attached files.). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our For information about this choice, including consent withdrawal, please see our For information about this choice, including consent withdrawal, please see our For information about this choice, including consent withdrawal, please see our Privacy Policy..-->

Reviewer #1: No

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