Understanding Midwives’ Perspective on Care of Post Cesarean Section Women at the University Teaching Hospital—Women and Newborn, Lusaka

Abstract

Background: A cesarean section is a major obstetric surgical procedure performed for the purpose of delivering a live baby when vaginal delivery would put the mother and the baby at risk due to complications of pregnancy, labour and delivery. Although caesarean section is a life saving procedure, it is associated with a number of risks or problems in the postoperative period. The aim of the study was to understand the Midwives' perspective on the care of postpartum mothers who had cesarean section at the University Teaching Hospital-Women and Newborn in Lusaka District. Methods: A descriptive cross sectional survey was conducted at the University Teaching Hospital-Women and Newborn in Lusaka. 51 Midwives working in postnatal wards were consecutively selected to participate in the study. Data was collected using a self administered questionnaire with a 4 point Likert scale and also some closed and open ended questions. SPSS version 20 statistical package was used to analyse data, expressed as descriptive summary measures. Results: All the 51 Midwives were female and they scored themselves highly on a 4 point Likert scale as always performing all the immediate post-operative care on the postpartum mothers who had a caesarean section while the score was much lower during the subsequent post-operative period. Staffing levels and medical-surgical materials were found to be low and affect care of Postpartum mothers (P-0.050). The majority (94.2%) of the Midwives also indicated that C-section mothers were not given any form of written materials or standardized instructions to take home as reference material during the

Knowledge and Attitudes on Selfcare Practices Following Child Birth by Caesarean Section at Marondera Hospital in Zimbabwe

“…Current study findings enrich previous studies which found that the most frequent reasons for not obtaining PNC were lack of time 14 (47%), long distance to a provider 7 (23%) and lack of guardians for other children care 9 (30%) [38]. Knowledge and positive attitude could result in alterations in the behavior in cases of practices that complicates the healing of the surgical site [42].…”

“…Proper guidance promotes maternal and neonatal wellbeing by adopting a holistic approach to care and prevent SSIs, wound sepsis, maternal morbidity and length of hospital stay after CS. Many women in the Sub-Saharan Africa, including Zambia, do not have access to health care during early postnatal period putting them at high risk of surgical site infections and death [38]. These researchers further reported that most of the deaths were reported to be associated with a number of risks or problems in the postoperative period that include SSI, wound gapping and puerperal sepsis.…”

“…Feeling well supported, receiving timely and consistent information are important factors contributing to women"s satisfaction with their postnatal care [38]. Following CS, good quality life and health of women can be improved through empowerment of both the women and their families by providing comprehensive post-operative education throughout the immediate recovery period and prior to discharge to reduce surgical wound contamination chances.…”

“…Therefore, provision of high standards of care and support to mothers and their babies during the postnatal period is the responsibility of the midwife. Lack of selfcare knowledge and attitudes of women may prompt the women to stop therapy, reduce or delay PNC [38]. The postnatal period presents an ideal opportunity for midwives to highlight the importance of selfcare practices especially after CS.…”