Quality of intra-partum care at a university hospital in Nepal: A prospective cross-sectional survey

Johanna Cederfeldt; Jenny Carlsson; Cecily Begley; Marie Berg

doi:10.1016/j.srhc.2015.11.004

Quality of intra-partum care at a university hospital in Nepal: A prospective cross-sectional survey

Sex Reprod Healthc. 2016 Mar:7:52-7. doi: 10.1016/j.srhc.2015.11.004. Epub 2015 Nov 27.

Authors

Johanna Cederfeldt¹, Jenny Carlsson², Cecily Begley³, Marie Berg⁴

Affiliations

¹ Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, P.O. BOX 457, SE 405 30 Gothenburg, Sweden. Electronic address: johanna.cederfeldt@gmail.com.
² Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, P.O. BOX 457, SE 405 30 Gothenburg, Sweden.
³ Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, P.O. BOX 457, SE 405 30 Gothenburg, Sweden; School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland.
⁴ Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, P.O. BOX 457, SE 405 30 Gothenburg, Sweden; Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.

PMID: 26826046
DOI: 10.1016/j.srhc.2015.11.004

Abstract

Objective: To investigate the quality of intra-partum care provided to women with an expected normal birth at a university hospital in Nepal.

Methods: A prospective cross-sectional study was conducted during three weeks in November 2013. Nurses at the labor ward collected data from 292 consecutive births. Of these, 164 women of low risk were expected to have a normal birth and were included in the study; 107 (65%) were nulliparous. The self-administered questionnaire covered maternal characteristics, previous pregnancies and births, current pregnancy, labor and birth. Nine items assessed care management, five of which comprised the Bologna score with a total possible score of 5: presence of a companion, use of partograph, non-use of augmentation, non-supine position, and skin-to-skin contact.

Results: The women were assisted by physicians (56%), nurses (42%) or students under supervision (2%). All were in good health after birth. Two had a postpartum hemorrhage exceeding 500 ml and 49% had an episiotomy. Apgar score in all neonates was ≥ 7 at five minutes. Mean Bologna score was 1.43 (variance 0-3).

Conclusions: The management of care in normal birth could be improved in the studied setting, and there is a need for more research to support such improvement.

Keywords: Bologna score; Intra-partum care; Nepal; Quality of health care; Survey.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Apgar Score
Cross-Sectional Studies
Delivery, Obstetric / standards*
Episiotomy / statistics & numerical data
Female
Hospitals, University / standards*
Humans
Incidence
Infant, Newborn
Labor, Obstetric*
Maternal Health Services / standards*
Nepal / epidemiology
Parity
Postpartum Hemorrhage / epidemiology
Pregnancy
Prospective Studies
Quality of Health Care*
Surveys and Questionnaires
Young Adult