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Management of intrapartum care in expected normal childbirth: A prospective cross-sectional survey at a university hospital in Nepal

Författare och institution:
Jenny Carlsson (Institutionen för vårdvetenskap och hälsa); Johanna Cederfeldt (Institutionen för vårdvetenskap och hälsa); Cecily Begleya (-); Marie Berg (Centrum för personcentrerad vård vid Göteborgs universitet (GPCC))
Publicerad i:
NJF (Nordiskt Jordemoderförbund) Congress. Programme and abstracts. Gothenburg, May 12-14, 2016, s. 42
Konferensbidrag - refereegranskat abstract
Sammanfattning (abstract):
Background Women and children die needlessly in childbirth every day. Appropriate care may prevent this, and keeping birth normal is crucial to reduce the risk of complications. Nepal has radically reduced maternal and neonatal mortality in the last decade, yet the numbers remain high. Of the initiatives implemented by the government to ensure safe motherhood, none focuses on improving normal, physiological processes of childbirth. Aim To study the quality of intra-partum care in expected normal childbirth at a university hospital in Nepal Methods: Following ethical approval, a prospective cross-sectional study using a structured questionnaire was conducted in November 2013. Over three weeks, nurses employed at the labor ward collected data from 292 consecutive women giving birth. Of these, 164 were expected to have a normal childbirth and 107 (65%) were nulliparous. The questionnaire covered; background variables, previous pregnancies and births, current pregnancy, and current labor and birth. Care management was assessed using nine items, including the five that constitute the Bologna score: presence of a companion, use of partograph, absence of augmentation, non-supine position, and skin-to-skin care. Results Births were assisted by physicians (56%), nurses (41%), and medical or nursing students under supervision (2%). The mean Bologna score was 1.43 (variance 0-3, min 0, max 5). Circa half of the women had an episiotomy and two had a postpartum hemorrhage of >500 ml. All women were well after birth, and all infants had an Apgar score ≥7 at five minutes. Conclusion Intra-partum care in expected normal childbirth must be continuously assessed to safe-guard the normal, physiological process. Results indicate a medicalized perspective in the studied setting, including an over-use of medico-technical intervention. One important activity to support normal childbirth is to establish the professional midwife, educated with the right competencies. To support such initiative, further activities including research are needed.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Postens nummer:
Posten skapad:
2016-05-19 11:24
Posten ändrad:
2016-06-02 13:45

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