Managing hypertensive disorders during pregnancy in low resource settings

BACKGROUND : Maternal deaths caused by hypertensive disorders are preventable. The purpose was to assess midwives’ perceived knowledge and skills on the implementation of maternal health guidelines when managing hypertensive disorders during pregnancy. METHODS : Quantitative, cross-sectional method was used. Population comprised of 200 midwives. Data was collected through self-report questionnaires and analysed through Statistical Package for Social Sciences 24. RESULTS : Midwives (63.5%) possessed knowledge and skills of implementing maternal guidelines. While 77.5% experienced shortage of human and material resources. Non-compliance to ambulance services led to delayed initiation of treatment. RECOMMENDATIONS : Continuous in-service training and education must be conducted. More resources to be provided to implement guidelines accurately.The South African Medical Research Council and the University of Venda Research and Publication Committee.https://www.tandfonline.com/loi/ihip20hj2019Nursing Scienc

The facilitating factors and barriers encountered in the adoption of a humanized birth care approach in a highly specialized university affiliated hospital

<p>Abstract</p> <p>Background</p> <p>Considering the fact that a significant proportion of high-risk pregnancies are currently referred to tertiary level hospitals; and that a large proportion of low obstetric risk women still seek care in these hospitals, it is important to explore the factors that influence the childbirth experience in these hospitals, particularly, the concept of humanized birth care.</p> <p>The aim of this study was to explore the organizational and cultural factors, which act as barriers or facilitators in the provision of humanized obstetrical care in a highly specialized, university-affiliated hospital in Quebec province, in Canada.</p> <p>Methods</p> <p>A single case study design was chosen. The study sample included 17 professionals and administrators from different disciplines, and 157 women who gave birth in the hospital during the study. The data was collected through semi-structured interviews, field notes, participant observations, a self-administered questionnaire, documents, and archives. Both descriptive and qualitative deductive content analyses were performed and ethical considerations were respected.</p> <p>Results</p> <p>Both external and internal dimensions of a highly specialized hospital can facilitate or be a barrier to the humanization of birth care practices in such institutions, whether independently, or altogether. The greatest facilitating factors found were: caring and family- centered model of care, professionals' and administrators' ambient for the provision of humanized birth care besides the medical interventional care which is tailored to improve safety, assurance, and comfort for women and their children, facilities to provide a pain-free birth, companionship and visiting rules, dealing with the patients' spiritual and religious beliefs. The most cited barriers were: the shortage of health care professionals, the lack of sufficient communication among the professionals, the stakeholders' desire for specialization rather than humanization, over estimation of medical performance, finally the training environment of the hospital leading to the presence of too many health care professionals, and consequently, a lack of privacy and continuity of care.</p> <p>Conclusion</p> <p>The argument of medical intervention and technology at birth being an opposing factor to the humanization of birth was not seen to be an issue in the studied highly specialized university affiliated hospital.</p

Mothers\' experience of labour in a tertiary care hospital

The purpose of the study was to explore and describe experiences of mothers during childbirth in a tertiary hospital in the Limpopo Province. This was achieved through a qualitative research study which was exploratory, descriptive, contextual and inductive in nature. A sample of 24 mothers participated in this study. Data obtained from unstructured in-depth interviews were analysed according to the protocol by Tesch (1990, cited in Cresswell, 1994:155). Five themes were identified, namely mutual participation and responsibility sharing, dependency and decision-making; information sharing and empowering autonomy and informed choices; open communication and listening; accommodative/non-accommodative midwifery actions; and maximising human and material infrastructure. The themes indicated experiences that foster or promote dependency on midwifery care. Guidelines on how to transform this dependency into a mother-centered care approach during childbirth are provided. Keywords: experience of labour; accommodative midwifery actions; maximise human and material infrastructure; midwife; South AfricaHealth SA Gesondheid Vol. 13 (1) 2008: pp. 55-6

Factors contributing to teenage pregnancy in the Capricorn district of the Limpopo Province

Teenage pregnancy refers to pregnancy of a woman of less than 19 years. It is found commonly amongst young people who have been disadvantaged and have poor expectations with regard to either their education or job market. Adolescents may lack knowledge of access to conventional methods of preventing pregnancy, as they may be afraid to seek such information. The study purpose was to identify factors contributing to teenage pregnancy in one village in the Capricorn District of the Limpopo Province.<p>A quantitative descriptive research approach was chosen. Population consisted of all pregnant teenagers attending antenatal care during June to August 2007 at one clinic in the Capricorn District of the Limpopo Province. Simple random probability sampling was used to include 100 pregnant teenagers who satisfied the inclusion criteria. Data were collected through structured self-administered questionnaires. Descriptive statistical data analysis was used. Ethical considerations were ensured.</p><p>Findings were classified as demographic data where 24% of the respondents were aged between 15–16 years and 76% were aged between 17–19 years. Findings further revealed that 60% of the respondents started to engage in sex at 13–15 years; 48% of the teenagers’ partners were 21 years and above, 44% depended on a single parents’ income; 20% father’s income, 16% received a social grant and 8% lived on the pension fund of the grandparents.</p><p>Pregnancy prevention strategies were recommended based on the results. The strategies focused on reproductive health services, male involvement and adult-teenager communication programmes.</p

Mothers knowledge of foetal movements monitoring during pregnancy in relation to perinatal outcome

Over the years, maternal perception of foetal movement has become recognised as a valuable tool for early detection of foetal compromise. Foetal movement is a reliable sign of foetal well-being (Bennett & Brown, 1999:232). Despite being a useful method in attaining clinical foetal monitoring, foetal movement is probably under-utilised, especially in high-risk pregnancy (Nolte, 1998:100). The purpose of this study was to determine the knowledge pregnant mothers have on the monitoring of foetal movement and its effect on perinatal outcome. The findings of the study were used to develop the content of a health education programme that is contextual and relevant to the needs of pregnant mothers. A quantitative research survey design was used to obtain information from pregnant mothers. Simple random probability sampling was used. Ninety-seven (97) pregnant mothers agreed to participate in the study. The results indicated that pregnant women who were able to perceive foetal movement during pregnancy regarded it as important. However, limited information on the importance of foetal movement monitoring in relation to perinatal outcome was displayed. Content on contextual health education for mothers on foetal movement monitoring was proposed. Keywords: knowledge; foetal movements monitoring; perinatal outcome Health SA Gesondheid Vol. 11 (2) 2006: pp. 13-2

“Motherhood is hard” : exploring the complexities of unplanned motherhood among HIV-positive adolescents in South Africa

Abstract: For any woman, pregnancy and giving birth are major life-changing experiences. This period is argued to indicate a shift from girlhood into womanhood. However, this experience takes on new meaning when the woman is very young—an adolescent, who is still in school—and learns that she is HIV-positive. For such adolescent, becoming a mother, just like living with HIV/ AIDS, involves moving from a known, current reality to an unknown, new reality. To understand how HIV-positive adolescent mothers grapple with the demands and responsibilities of unplanned motherhood while living with HIV, this study explores the complexities of their experiences in South Africa. Drawing on qualitative methods, this study examines their meaning to motherhood while meeting their personal health needs. Through in-depth interviews conducted among 10 HIV-positive adolescent mothers living in Johannesburg, this article presents an empirical study of their narratives and how they negotiate these complexities in their unplanned new realities. Emerging themes from the interview transcripts were identified, coded, and analyzed thematically following an interpretivist approach. From the interviews conducted, it is evident that HIV-positive adolescent mothers perceive unplanned motherhood as difficult and this negatively affects their future childbearing decisions. Given the importance of motherhood and adolescents globally, this article advocates for feminist policies that would facilitate larger transformative narratives. It also recommends the implementation of relevant policy that would alleviate the difficulties of HIV-positive adolescent mothers generally