A descriptive, cross-sectional study of postpartum education: midwives’ self-reported knowledge and teaching of postpartum complications in Ghana

Abstract

Background Obstetric complications remain the leading causes of maternal deaths. Since it is not always possible to ascertain which women will develop complications and which women will not, all women who have a baby should be educated about warning signs of complications. In this study, we assessed postpartum education provided by midwives, midwives’ knowledge to teach patients about complications and their skills to manage postpartum complications. Methods Descriptive, cross-sectional study of 245 midwives in four hospitals in Tamale, Ghana, using an electronic questionnaire. Data analyzed in Stata 16 software using descriptive, bivariate, and multivariate statistics. Results Majority of midwives were female (98%). Mean age of midwives was 32 years. Most midwives spent 6 to 15 min teaching patients on warning signs of complications (61.89%). Mode of discharge education was mostly individual (83.13%). Most midwives reported no reference materials given to patients (66.39%). About 93.45% of midwives strongly agreed or agreed it is their responsibility to teach all patients, regardless of risk factors, about warning signs of complications. However, midwives did not always teach patients about complications. The majority of midwives felt they were knowledgeable or very knowledgeable to teach patients about hemorrhage (95.08%), infection (94.67%), preeclampsia/ eclampsia (90.95%), and hypertension (89.35%). Similarly, most midwives felt they had the skills to manage these same four obstetric complications. Unsurprisingly, most midwives were more likely to always educate their patients about hemorrhage, infection, preeclampsia/ eclampsia, and hypertension—the complications they were more knowledgeable about. Many midwives felt not knowledgeable about and not competent to manage postpartum depression, cardiac events, pulmonary embolism, and venous thrombosis. In the same regard, many midwives did not teach patients about the life-threatening complications they were least knowledgeable about. Conclusions Midwives did not always teach patients about complications. Most midwives felt knowledgeable to teach and manage hemorrhage, infection, and preeclampsia/hypertension but not cardiac events, pulmonary embolism, and venous thrombosis. Additional training of midwives on life-threatening complications such as pulmonary embolism and cardiac events is recommended.

Enhancing functional recovery following postpartum femoral neuropathy: early neurorehabilitation and multidisciplinary obstetric care

“…In patients after neuraxial block with lumbar pain, fecal/ urinary incontinence, or motor/sensitivity deficits that do not improve with time, it is mandatory to perform preferably an MRI to rule out compressive lesions such as epidural hematoma. 4,14,15 | 833 MOITA GONÇALVES et al…”

“…Associated risk factors of obstetric neurologic injuries are primiparity, instrumental delivery, and regional anesthesia. In patients after neuraxial block with lumbar pain, fecal/urinary incontinence, or motor/sensitivity deficits that do not improve with time, it is mandatory to perform preferably an MRI to rule out compressive lesions such as epidural hematoma 4,14,15 …”

Improving the Quality of Postpartum Care in Ghana: Protocol for a Parallel Randomized Controlled Trial

“…However, several studies have reported that postpartum women in transitional countries experience inadequate knowledge of postpartum warning signs of complications [11][12][13][14]. Furthermore, midwives working in Tamale, Ghana, have self-reported inadequate knowledge and skill sets to adequately educate patients about all detrimental postpartum complications and how to manage those complications [15,16].…”