Browsing by Author "Mlambo, Sarah"
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- ItemMidwives’ views on delivery method decision making in private sector labour wards of Namibia(Stellenbosch : Stellenbosch University, 2018-03) Mlambo, Sarah; Cramer, Jenna Morgan; Young, Cornelle; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery.ENGLISH SUMMARY: Background: The views of midwives regarding decision making in the Namibian private sector hospital labour wards are investigated in this study. The high prevalence of caesarean sections in the Namibian private sector has been the motivation to attempt to understand this phenomenon. Midwives are an integral part in the care of women as prioritised patients, before, during and after childbirth. The objectives of the study included the midwives’ views on how women in the labour wards decide on a birthing method, whether the Robson classification for doing caesarean section was being applied in their workplaces, and what their perceived role as advocates entails during the women’s decision making of her birthing mode. Methods: The study used a qualitative design with an exploratory approach. Purposive sampling was applied in the selection of research participants. Permission was granted by the Health Research Ethics Committee of Stellenbosch University and the management of the two hospitals selected for the study. Seven individual interviews for allowing the phenomenon to be explored in-depth were conducted in two private hospitals in Windhoek. Data analysis was done using the six steps by Creswell. Results: The seven midwives who participated in this study reported that the decisions in the labour wards are affected by a myriad of factors. These include the relationship the midwife has with the doctor, the patient and the institution; trust among and between health professionals, and the availability of adequate antenatal information for the women to make informed decisions about the mode of birth. The following themes and subthemes (in brackets) emerged from the study: midwife (dependent, interdependent and independent role functions); doctor (dependent, interdependent and independent role functions; instrumental and expressive roles; motivations for caesarean sections); patient (antenatal care and expectations of pain management in labour; presence of support or birthing partner); and hospital (policies and guidelines; Robson classification). The study found that women are not well informed about the choices they have for childbirth, about the advantages and disadvantages of the chosen mode of delivery, as well as what to expect during the active stages of labour. The notion that some decisions are influenced by convenience also emerged in this study. Midwives’ roles in the Namibian private sector context were found to include decreased independent and increased interdependent functions due to the enlarged role of the private doctor as the primary care-giver, as well as expectations of the institution and the doctor. Conclusion: Decision making in the labour wards is important, as it determines the birthing method outcome for every woman in the labour ward. Health information during antenatal care needs to be improved to empower women with knowledge, for them to make informed decisions regarding the mode of delivery. The views of midwives emphasised the advocacy role on the part of the midwife, who needs to be more assertive in this role to benefit women in labour. Further studies need to be done in the same context and public hospital settings, to compare the views of women on decision making in the labour wards.
- ItemWomen’s decision making on birthing choices in the private sector of Namibia : midwives’ perspectives(Unisa Press, 2020) Mlambo, Sarah; Young, Cornelle; Morgan-Cramer, JennaIn this study, the views of midwives regarding decision making in the Namibian private sector hospital labour wards were investigated with the aim of understanding the reasons for the high prevalence of caesarean sections in the Namibian private sector. The study objective was to determine the views of midwives about how women in the private sector labour wards decide on a birthing method. A qualitative design with an exploratory approach was followed, with the application of purposive sampling in the selection of research participants. Seven individual and in-depth interviews with midwives were conducted in two private hospitals in Windhoek. Data analysis was done using the six steps proposed by Creswell. Findings indicated that decision making depended on the woman, the doctor and the institution. Aspects such as the midwife’s relationship with the doctor, as well as the pregnant woman and the institution have an influence on such decisions made. Furthermore, the trust among and between health professionals, the availability of policies and guidelines, as well as the information received during antenatal care also affect the choice. It was found that women are not well informed about the choices they have for childbirth, the advantages and disadvantages of the chosen mode of birthing, as well as what to expect during the active stages of labour. In conclusion, decision making in the labour wards is important as it determines the birthing method outcome for every woman in the labour ward. Further studies need to be done in the same context and public hospital settings, to explore the dynamics in the public sector.