Objectives
This study aimed to explore childbirth fear and childbirth preparation among primigravid women in the late pregnancy from 36 to 40 weeks gestation
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Methods
We purposively recruited 18 primigravid women into in-depth interviews, 21 birth companions, and 13 health workers into focus group discussions. Participants were recruited from two community hospitals’ maternity waiting homes in Lilongwe, Malawi. Semi-structured interview guides were used to collect data that were analyzed using content analysis. NVivo11 computer software was used to organize the data.
Results
The four categories developed were: “ambivalent pregnancy feelings” , “dependence on traditional childbirth counseling” ,“inadequate prenatal childbirth instruction” and “inconsistent roles of a birth companion” . The findings suggest that primigravid women who were mainly exposed to traditional childbirth mentoring rather than professional care providers, experienced childbirth fear, and lacked proper psychosocial childbirth preparation.
Conclusions
Childbirth fear among primigravid women emanate from personal; family; ineffective traditional counseling; and inadequate antenatal childbirth instruction. Birth companions may increase childbirth stress. However, our findings highlight birth companions as readily available psychosocial support resources among primigravid women. We recommend that professional childbirth instruction during antenatal care should be strengthened to surpass traditional childbirth counseling. Appropriateness and effectiveness of birth companions need to be carefully assessed.
Background/Objectives: Malawi is one of the countries in the world with the worst maternal mortality rate. In view of this, women are encouraged to deliver at a health facility assisted by a skilled birth attendant. However, this initiative can only be effective when health care workers manifest a professional demeanor which conveys care and compassion to patients/clients. The objective of the study was to foster the development of compassionate care among nurses/midwives working in selected maternal and child health care clinical settings. Methods: The study employed an action research (AR) approach. Focus group discussions (FGDs) were conducted with nurse/midwives from the selected health facilities. Purposive sampling was utilized to obtain the sample of participants to the eight FGDs and thematic analysis was used to analyze the data. Results: The data collected from nurses/midwives clearly indicate that it is not possible to effectively render compassionate care under the present work conditions. The study reveals the following factors which hinder the delivery of compassionate care: severe nursing shortages, gross lack of essential supplies and equipment, negative attitudes of nurses/midwives and unsupportive leadership which demotivates nurses/midwives. Conclusion:The study reveals problems which hinder the delivery of compassionate care, and there is need to address these problems. This will enhance the effectiveness of hospital delivery by a skilled birth attendant as a safe motherhood initiative aimed at lowering the high maternal mortality rate.
Assessment and prescribing practices for women attending out-patient clinics who might be in early pregnancy were inadequate, increasing the risk of exposure to potentially feto-toxic medicines.
Male involvement in maternal and child health has been promoted since the 1994 International Conference on Population and Development in Cairo. Literature from high-resource settings demonstrates the benefits of involving males in maternal and child health including improvement in maternal mental health, increased assistance from partners and reduced stay in hospital; however, little is known about the situation in low-income countries. This paper aims to provide a descriptive review of qualitative studies on experiences of men who supported their partners during labour and birth in low-resource settings. Themes identified from the literature include: unpreparedness, pleasant but frightening experience, loss of interest in wife and lack of privacy. Further good quality studies should be performed in addition to the need for adequate preparation of men for involvement during labour and birth.
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