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.
Keywords: Discharge education; Maternal health; Maternal mortality; Midwives; Postpartum; Postpartum complications.
Complications after childbirth are the leading causes of maternal deaths. All women who have a baby should be educated about the warning signs of complications. In this study, 245 midwives from four hospitals in Tamale, Ghana, completed questions that assessed the education they provide to patients on potential complications after childbirth, their knowledge to teach patients about complications, and their skills to manage complications after birth. Midwives reported that patients stay in the hospital for a day or less if they delivered vaginally or for 3 or more days if they delivered by cesarean section. About 62% of midwives spent 6 to 15 min teaching patients on warning signs of complications; 82% provided individual teaching during discharge; and 66% did not provide take-home educational materials to patients. About 93% of midwives either strongly agreed or agreed that it is their responsibility to teach all patients about warning signs of complications. Results indicated that midwives did not always teach patients about potential complications that can occur after childbirth. Midwives more frequently taught patients about severe bleeding, infections, and complications of high blood pressure, and least frequently taught patients about heart-related complications, blood clots and depression after birth. Most midwives felt they were knowledgeable to teach and manage severe bleeding (hemorrhage), infection, and complications related to high blood pressure (preeclampsia/eclampsia) but not heart-related complications (cardiac events), blood clots in lungs (pulmonary embolism), blood clots in deep vein, usually in legs (venous thrombosis), and depression after childbirth.
© 2022. The Author(s).