Background: The physiological and psychological changes caused by pregnancy may increase a woman’s vulnerability to depression, which may in turn have adverse effects on both maternal and foetal wellbeing. Inadequate psychosocial risk assessment of women by midwives may lead to lack of psychosocial support during pregnancy and childbirth. Pregnant women who lack psychosocial support may experience stress, anxiety and depression that could possibly affect foetal wellbeing.Objective: The objective of this study was to explore and describe the perception of psychosocial risk assessment and psychosocial care by midwives providing antenatal care to pregnant women.Method: An interpretive and descriptive qualitative approach was adopted. Three focus group interviews were conducted with midwives working in three Maternal Obstetric Units in Gauteng Province, using a semi-structured interview guide. The constant comparison data analysis approach was used.Results: Findings revealed that midwives are aware of and have encountered a high prevalence of psychosocial problems in pregnant women. Furthermore, they acknowledged the importance of psychosocial care for pregnant women although they stated that they were not equipped adequately to offer psychosocial assessment and psychosocial care.Conclusion: The findings provided a basis for incorporation of psychosocial care into routine antenatal care. Agtergrond: Die fisiologiese en psigologiese veranderings wat deur swangerskap veroorsaak word, kan ‘n vrou se kwetsbaarheid vir depressie verhoog. Dit kan op sy beurt negatiewe gevolge vir sowel die moeder as die fetus se welstand hê. As vroedvroue nie voldoende psigososiale riskio-assesserings op swanger vrouens doen nie, kan dit tot ‘n gebrek aan psigososiale ondersteuning tydens die swangerskap en geboorte lei. Swanger vrouens wat ‘n gebrek aan psigososiale ondersteuning het, kan stres, angs en depressie ervaar wat weer die fetus se welstand kan beïnvloed.Doelwit: Die doelwit van hierdie studie was om die persepsies van vroedvroue, wat voorgeboortesorg aan swanger vrouens bied, te ondersoek en te beskryf sover dit hulle persepsies oor psigososiale risiko-assessering en psigososiale aangaan.Metode: ’n Interpretatiewe en beskrywende kwalitatiewe benadering is gevolg. Drie fokusgroep-onderhoude is deur middel van ‘n gestruktureerde onderhoudsgids gevoer met verloskundiges wat in drie voorgeboorteklinieke in die Gauteng Provinsie werksaam is. ’n Benadering tot data-analise wat van voortdurende vergelyking gebruik maak, is gevolg.Resultate: Die studie het aan die lig gebring dat verloskundiges bewus is van psigososiale probleme onder swanger vroue en dat die prevalensie van sulke probleme onder swanger vroue hoog is. Vroedvroue erken die belang van psigososiale sorg aan swanger vroue alhoewel hulle nie toereikend toegerus is om psigososiale assessering en -sorg te verleen nie.Gevolgtrekking: Die bevindinge stel ’n basis daar vir die insluiting van psigososiale sorg in roetine voorgeboortesorg.

A partograph is a graphical presentation of a woman's progress of labour. Once the woman has true signs of labour, the midwife initiates the use of the partograph to record her findings. The partograph was endorsed and modified by the World Health Organisation (WHO) between 1990 and 2000 to monitor the fetal and maternal wellbeing during the active stage of labour. Monitoring help the midwives and the mother in achieving spontaneous vaginal delivery with low risk of both morbidity and mortality. Furthermore, accurate partograph recordkeeping enables an effective communication between healthcare professionals who manage women in labour. Documentation and recordkeeping have always been integral to midwifery practice and continue to be so. The aim of the study was to establish the perception of the use of the partograph by midwives, and to establish and describe the factors that contribute to the underutilization of the partograph by midwives during the management of labour. The context of the study was an Academic Hospital and a Midwifery seminar, Gauteng Province, South Africa. A cross-sectional descriptive quantitative study was conducted. Sampling was purposeful. A self-administered questionnaire was used to collect data. The findings revealed that midwives understood the importance of the use of the partograph but do not effectively use it due to a number of factors.

Background The provision of optimal and quality services during labour, delivery and in the early neonatal period is highly required to accelerate the reduction of neonatal deaths and improve the quality of life of newborns. The availability of competent health professionals and the essential medicines and supplies in the health facilities are compulsory. Cost-effective interventions exist to prevent more than 80% of all newborn deaths. However, an unacceptably high number of newborns are dying in the study area, and much is not known about the main contributing factors in primary healthcare settings. This study aimed to explore and describe the quality of care provided to newborns in the primary healthcare units. Methods Qualitative exploratory and descriptive design was employed. Focus group discussions were held with 26 participants (11 health workers and 15 health extension workers) in three woredas in the West Gojjam zone, Ethiopia. Health workers and health extension workers were purposely selected. Thematic analysis was undertaken. Results The primary healthcare facilities play a major role in the provision of essential services for newborns in the critical periods, including during labor and birth, immediately after birth and in the early postnatal care period. Resuscitation of birth asphyxia, prevention of hypothermia, initiation of breastfeeding, application of tetracycline, vitamin k injection, weighing babies and chlorhexidine application were identified as immediate essential intervention for the newborns. However, these interventions are hampered by factors such as lack of adequately trained staff & hands-on skills; weak referral linkage; stock-out of essential medicines and supplies and poor quality for early postnatal care home visits. Conclusions In order to enhance the quality of newborns healthcare provision, the health-systems constraints at health centres and heath posts level should be fixed to provide the required services for newborns. This requires allocation of adequate resources to tackle health facilities readiness related bottlenecks, such as the frequent stock out or lack of essential supplies, equipment, and medicines, lack of proper space for the service provision, not systematic replenishing of the revised job-aids and maintenance of medical equipment, poor infection prevention including water and sanitation in the maternity wards and newborn corners.

From a feminist perspective, research on childbirth and women’s health is a means to a positive change that is conducted in partnership with women for their benefit. A patient-led National Health System (NHS) (Hillan, 1999) also calls for consultation with patients and the wider public for shaping the current and future health services. This study was aimed at exploring and describing the expectations that pregnant women have regarding antenatal care service by the midwife practitioner. In-depth interviews were conducted in an antenatal unit of an Academic Hospital in Gauteng Povince. Data saturation was reached with a sample of eighteen pregnant women who were conveniently selected. Data analysis ran concurrently with data collection. A manual content analysis as described by Tesch was used. Lincoln and Guba’s method of ensuring trustworthiness was adopted (Lincoln & Guba, 1985:328

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The rationale of any national screening programme is to recognise the benefits for public health, to assess a predominantly healthy population including pregnant women and to detect risk factors for morbidity in order to provide timely care interventions. The focus of antenatal care screening is to identify wider determinants of health that may have an impact on a pregnant woman's well-being that includes the physical, psychological, social and religious factors. Psychosocial risks, among others, include poor socioeconomic conditions such as poverty, lack of social support, general health inequalities, domestic violence and a history of either personal or familial mental illness, all of which have the capacity to influence a pregnant woman's decision to utilise health care services. This chapter highlights the antenatal care process, the importance of psychosocial care during pregnancy, maternal risks during pregnancy, the impact of pregnancy on maternal well-being, the possible psychosocial risk factors during pregnancy, psychosocial assessment, psychosocial care as a missing piece of the antenatal care puzzle, the presentation of the results of a study on psychosocial risk assessment and support and further outlining various antenatal care approaches that could be adopted to offer pregnant women holistic care.

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Background. Midwives provide the majority of maternal and child healthcare in South Africa (SA). The care provided by midwives during childbirth is a unique life experience for women, and in order to provide safe care, midwives are expected to comply with ethical principles, policies and legislation governing their profession, as guided by the International Confederation of Midwives. Objective. To establish midwives’ perception of ethical and professional practice in selected labour units of public healthcare, in Tshwane District, Gauteng Province, SA. Methods. A qualitative, exploratory, descriptive cross-sectional design was applied by use of in-depth interviews. Non-probability purposive sampling was used to draw a sample from midwives with 2 or more years of experience working in the labour units. Data saturation was reached with the eighth participant. The digitally recorded interviews were transcribed verbatim. Data analysis was based on interpretive description. Results. The findings revealed that midwives do understand the ethical code of conduct. They experience challenges such as staff shortages, non-compliance with policies and lack of managerial support, which compromise ethical conduct to a certain extent. Conclusion. It is hoped that the suggested administrative, midwifery practice and research recommendations will guide the process of empowering midwives in ethical practice.