Objectives This study aimed to explore childbirth fear and childbirth preparation among primigravid women in the late pregnancy from 36 to 40 weeks gestation . 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.
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.
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.
Background Caring is a core function of nurses and it confers upon them ethical obligations as ethical agents. Failure to carry out such ethical obligations raises ethical concerns. This study was not intended to explore ethical concerns, but the reported findings reveal problems which have ethical implications. This paper aims to elucidate the ethical issues inherent in the findings and propose strategies to mitigate them. Research design and methods An exploratory-descriptive qualitative design was used within a larger Action Research Study. Data were collected through focus group discussions with nurse/midwives, and through exit interviews which were conducted with the women who participated in the study on their day of discharge. Six focus group discussions and thirty exit interviews were conducted, and data were analysed through thematic analysis. Participants and research context The study took place at selected maternal and child healthcare settings in Lilongwe, Malawi. The participants were nurse/midwives and women who were admitted in maternal and child healthcare settings and were purposively sampled. Ethical considerations Ethical approval was obtained from the relevant ethics committee and all ethical guidelines were followed in the conduct of the study. Findings The findings are presented under three themes which emerged from the data. The findings reveal effects of staff shortages on patient outcomes, problems experienced in low resource clinical settings and disrespectful nurse/patient communication. Conclusion The findings reveal that institutional factors constrain moral agency and patient safety is severely compromised in some of the clinical settings in Malawi which raises serious ethical concerns.
Background/Aim: Medication use by women of childbearing age is common and cannot be totally avoided because some pregnant women may have chronic pathological conditions that require continuous or uninterrupted treatment. Women may hold different beliefs about the use of medication during pregnancy, which affects their use. This study explores women's beliefs, views and practices concerning medication use during pregnancy. Methods: In this qualitative study, semi-structured interviews were held with 21 pregnant women (age range: 20–39 years) during their first visit to an antenatal clinic at Mitundu Community Hospital in Malawi. Data were collected using an interview guide between February and July 2010. Results: This is the first study in Malawi to interview women about their beliefs and views on medication use in early pregnancy. Notably, most women interviewed in this study did not rely wholly on western or traditional medicine, but used both. This was irrespective of age, parity and educational level. Three overarching themes emerged from the analytical process, namely: i) beliefs about modern and traditional medicines; ii) choice of medication during pregnancy; iii) protection from witchcraft. Conclusions: In general, the beliefs, views and practices of women concerning medication use during pregnancy demonstrate a reliance on superstitious or cultural beliefs to explain the causes of complications during pregnancy. Most of the women interviewed in this study had limited exposure to information, resulting in ignorance of medication use during pregnancy. Women need to be much better educated and encouraged to ask questions so that they are less accepting of superstitious beliefs.
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