The stress of the midwife: Experiences of advanced midwives working in obstetric emergency units in Johannesburg, South Africa

Obstetric emergencies account for the majority of causes of maternal deaths. The major causes of maternal and neonatal deaths in obstetric emergencies include bleeding, pregnancy-induced hypertension, cord prolapse, shoulder dystocia, poor progress, placenta abruptio, placenta praevia and amniotic fluid embolism. These adverse labour and birth events cause emergency situations and trauma for the nursing staff involved. A qualitative, descriptive phenomenological research design was used to explore and describe the lived experiences of advanced midwives regarding the management of obstetric emergencies in Midwife Obstetric Units (MOUs) of Gauteng Province, South Africa. An interview guide was prepared with a major question which was followed by probing questions based on the participant’s responses. Semi-structured, face-to-face individual interviews were used to collect data from thirteen (13) advanced midwives who were purposively selected and had been working in the Midwife Obstetric Units for two years or more after obtaining their qualifications. The Midwife Obstetric Units were selected based on the records of their birth statistics. The seven Collaizi’s procedural steps were utilised for data analysis. Measures to ensure the trustworthiness of the study were observed within the naturalistic paradigm comprising criteria of credibility; transferability; dependability; and confirmability. Three themes with sub-themes emerged from the current study, namely: psychosocial stress; advanced midwives’ workload; and lack of professionalism. In conclusion, it was evident that advanced midwives experience psychosocial stress because of unconducive working environments which are not adequately resourced, and high expectations from patients and their families. Management should support advanced midwives with the necessary resources that will enable them to perform their duties effectively and minimise their levels of stress and trauma. (Afr J Reprod Health 2021; 25[5]: 93-104)

Can women’s lives be saved from hypertensive disorders during pregnancy? Experiences of South African midwives

A qualitative, descriptive phenomenological research design was conducted to explore and describe the experiences of midwives on the management of women diagnosed with hypertensive disorders during pregnancy in rural areas of Limpopo Province, South Africa. Non-probability sampling was used to select eighteen (18) midwives from primary health care facilities of Mopani and Vhembe districts in Limpopo Province. Data was collected through in-depth interview and analysed using eight steps of Tesch‘s open coding method. Ethical considerations were adhered to by ensuring confidentiality, anonymity, privacy and signing of informed consent by participants. Measures to ensure trustworthiness; credibility, transferability, dependability and last ly, confirmability were ensured. Findings of this study revealed three themes (with sub-themes) namely; management of pregnant women diagnosed with hypertensive disorders, support experienced when managing complications, challenges experienced by midwives when managing hypertensive disorders during pregnancy. In conclusion, poor support came up very strongly as a factor influencing good management of hypertensive disorders in pregnancy. Recruitment of more midwives that will support each other during management of pregnant women with hypertensive disorders is recommended.Une conception qualitative et descriptive de la recherche phénoménologique a été menée pour explorer et décrire les expériences des sages-femmes sur la prise en charge des femmes diagnostiquées avec des troubles hypertensifs pendant la grossesse dans les zones rurales de la province du Limpopo, en Afrique du Sud. Un échantillonnage non probabiliste a été utilisé pour sélectionner dix-huit (18) sages-femmes dans les établissements de soins de santé primaires des districts de Mopani et Vhembe dans la province de Limpopo. Les données ont été collectées par le biais d‘interviews approfondies et analysées en utilisant huit étapes de la méthode de codage ouvert de Tesch. Les considérations éthiques ont été respectées en garantissant la confidentialité, l'anonymat, la confidentialité et la signature du consentement éclairé des participants. Mesures visant à garantir la fiabilité; la crédibilité, la transférabilité, la fiabilité et enfin la confirmabilité ont été assurées. Les résultats de cette étude ont r évélé trois thèmes (avec des sous-thèmes) à savoir; prise en charge des femmes enceintes diagnostiquées de troubles hypertensifs, accompagnement expérimenté lors de la gestion des complications, difficultés rencontrées par les sages-femmes lors de la gestion des troubles hypertensifs pendant la grossesse. En conclusion, un mauvais soutien est apparu très fortement comme un facteur influençant la bonne gestion des troubles hypertensifs pendant la grossesse. Il est recommandé de recruter davantage de sages - femmes qui se soutiendront mutuellement pendant la prise en charge des femmes enceintes souffrant de troubles hypertensifs.The South African Medical Research Council, the University of Venda and the National Research Foundation of South Africa.https://journals.co.za/content/journal/ajrham2020Nursing Scienc

Can Women’s Lives be saved from Hypertensive Disorders during Pregnancy? Experiences of South African Midwives

A qualitative, descriptive phenomenological research design was conducted to explore and describe the experiences of midwives on the management of women diagnosed with hypertensive disorders during pregnancy in rural areas of Limpopo Province, South Africa. Non-probability sampling was used to select eighteen (18) midwives from primary health care facilities of Mopani and Vhembe districts in Limpopo Province. Data was collected through in-depth interview and analysed using eight steps of Tesch‘s open coding method. Ethical considerations were adhered to by ensuring confidentiality, anonymity, privacy and signing of informed consent by participants. Measures to ensure trustworthiness; credibility, transferability, dependability and lastly, confirmability were ensured. Findings of this study revealed three themes (with sub-themes) namely; management of pregnant women diagnosed with hypertensive disorders, support experienced when managing complications, challenges  experienced by midwives when managing hypertensive disorders during pregnancy. In conclusion, poor support came up very strongly as a factor influencing good management of hypertensive disorders in pregnancy. Recruitment of more midwives that will support each other during management of pregnant women with hypertensive disorders is recommended. Keywords: Hypertensive disorders in pregnancy, midwives, maternal death, South AfricaUne conception qualitative et descriptive de la recherche phénoménologique a été menée pour explorer et décrire les expériences des sages-femmes sur la prise en charge des femmes diagnostiquées avec des troubles hypertensifs pendant la grossesse dans les zones rurales de la province du Limpopo, en Afrique du Sud. Un échantillonnage non probabiliste a été utilisé pour sélectionner dix-huit (18) sages-femmes dans les établissements de soins de santé primaires des districts de Mopani et Vhembe dans la province de Limpopo. Les données ont été collectées par le biais d‘interviews approfondies et analysées en utilisant huit étapes de la méthode de codage ouvert de Tesch. Les considérations éthiques ont été respectées en garantissant la confidentialité, l'anonymat, la confidentialité et la signature du consentement éclairé des participants. Mesures visant à garantir la fiabilité; la crédibilité, la transférabilité, la fiabilité et enfin la confirmabilité ont été assurées. Les résultats de cette étude ont révélé troisthèmes (avec des sous-thèmes) à savoir; prise en charge des femmes enceintes diagnostiquées de troubles hypertensifs, accompagnement expérimenté lors de la gestion des complications, difficultés rencontrées par les sages-femmes lors de la gestion des troubles hypertensifs pendant la grossesse. En conclusion, un mauvais soutien est apparu très fortement comme un facteur influençant la bonne gestion des troubles hypertensifs pendant la grossesse. Il est recommandé de recruter davantage de sagesfemmes qui se soutiendront mutuellement pendant la prise en charge des femmes enceintes souffrant de troubles hypertensifs. Mots-clés: Troubles hypertensifs pendant la grossesse, les sages-femmes, la mort maternelle, Afrique du Su