Peer-reviewed article
Midwives' experiences and perceptions on the use of the Labour Care Guide: A qualitative study.
Tomas N, Poroto A ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study explores how midwives in Namibia experience and perceive using the Labour Care Guide, a WHO-endorsed tool for managing childbirth. Midwives generally found the guide useful for monitoring labour and detecting complications, but some raised concerns about its applicability to women using traditional oxytocin remedies. Implementation challenges included lack of resources and cultural factors around labour companionship. The study recommends further work to adapt the guide for safer management of women using traditional labour medications.
Key points
- Midwives expressed overall satisfaction with new components of the Labour Care Guide
- Some midwives identified a limitation: the guide does not adequately address monitoring and managing labour in women who consumed traditional oxytocin (Sivatu), which increases risk of uterine rupture, foetal distress, or death
- Lack of resources and cultural norms on labour companionship posed challenges to implementing the guide
- Midwives found the guide useful for monitoring labour progress and identifying abnormalities and complications
- Study recommends exploring alternative methods and strategies for safe labour monitoring and management in this context
Limitations
This is a qualitative study with only 10 midwives from one training hospital in Namibia, so findings cannot be generalised to all midwives or settings. The study captures perceptions and experiences but does not measure clinical outcomes or the actual impact of the guide on maternal and neonatal mortality and morbidity.
Abstract
Background Over one-third of maternal deaths, nearly half of stillbirths, and a quarter of neonatal deaths are attributed to complications during labour and childbirth. Currently, the Labour Care Guide (LCG) is the only tool that promotes the implementation of the World Health Organization's recommendations on intrapartum care, ensuring a positive childbirth experience. Previous studies examining midwives' experiences in utilising the LCG did not include Namibia, hence this study. Objectives This study aimed to explore and describe midwives' experiences and perceptions of using the LCG at a training hospital in Namibia. Method An exploratory descriptive qualitative design was employed to collect data from 10 midwives between May 2023 and July 2023. The interviews were audio-recorded, transcribed, and analysed using inductive reflective thematic analysis. The study adhered to the Consolidated Criteria for Reporting Qualitative Research reporting guideline. Results The study identified three themes: LCG optimisation challenges, perceived usefulness of LCG and suggestions for improvement. While midwives expressed overall satisfaction with the new components of the LCG, some midwives perceived a shortcoming with regard to monitoring and managing labour progress in mothers who consumed traditional oxytocin known as Sivatu as being at risk for uterine rupture, foetal distress, or even death. The lack of resources and cultural norms on labour companionship poses LCG implementation challenges. Conclusion This study found that while some midwives embraced the use of the LCG for monitoring labour and identifying abnormalities and complications, others perceived a limitation pertaining to monitoring women using traditional oxytocin.Contribution: The study thus recommends exploring alternative methods and strategies for safe labour monitoring and management.