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Birth practices in Port Harcourt, Nigeria: a retrospective case study review

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dc.contributor.authorDiorgu, F.
dc.contributor.authorSteen, M.
dc.date.issued2016
dc.description.abstractIntroduction: During a student nurse-midwives portfolio review in 2013, it was noted that a high proportion of women had a caesarean section and that all vaginal births were performed in a lithotomy position. The lithotomy birthing position is associated with increased risk of an episiotomy. This instigated the undertaking of a retrospective review of maternity case notes of 569 women, who gave birth at the two maternity hospitals in Port Harcourt, Nigeria in July, 2012. Aim and objectives: The aim of this case study was to confirm recorded birth data in student nurse-midwives portfolios and review some birth practices. The objectives were to explore whether lithotomy position for birth and the common use of episiotomy practices were supported by evidence. In addition, to justify the need to undertake research to explore mothers, midwives and obstetricians’ perspectives regarding these birth practices in Port Harcourt, Nigeria Findings: The review confirmed the recorded data in student nurse-midwives portfolios, a high rate of caesarean sections being performed (46%) and that vaginal births were undertaken in the lithotomy position.The review reported that all (100%) of the women who had a spontaneous vaginal birth did so in the lithotomy position.No justification for adopting a lithotomy position was documented in any of the women’s case notes reviewed. This review demonstrates that the lithotomy position is a routine practice, women are not given any alternative options and therefore women are led to believe that lithotomy is the accepted and standard position when giving birth. From the sample of 306 women who had a vaginal birth, 142 had perineal injuries. Majority (n = 90, 63%) of the women gave birth with an episiotomy performed, whilst (n = 52, 37%) sustained spontaneous perineal tears. Of the women who had episiotomy, the majority (n = 73, 81%) were primiparous. The severity of the perineal tear was not recorded and some of the case notes (n = 36,12%) did not document the perineal outcome. Conclusions: This retrospective case study review confirms a high proportion of caesarean section and episiotomy being performed and lithotomy position being used for birth. These practices are not based on evidence. Therefore, there is a clear justification to undertake a research study to explore further why these birth practices are not based on evidence and to gain an insight into mothers, midwives and obstetricians perspectives regarding birth practices.
dc.identifier.citationInternational Journal of Womens Health and Wellness, 2016; 2(5):1-4
dc.identifier.issn2474-1353
dc.identifier.urihttps://hdl.handle.net/11541.2/123208
dc.language.isoen
dc.publisherClinMed International Library
dc.rightsCopyright 2016 Diorgu and Steen. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
dc.source.urihttps://www.clinmedjournals.org/articles/ijwhw/international-journal-of-womens-health-and-wellness-ijwhw-2-037.php?jid=ijwhw
dc.subjectcase study review
dc.subjectbirth practices
dc.subjectevidence-base practice
dc.subjectlithotomy positions for birth
dc.subjecterineal trauma
dc.subjectepisiotomy
dc.subjecteducation and knowledge
dc.titleBirth practices in Port Harcourt, Nigeria: a retrospective case study review
dc.typeJournal article
pubs.publication-statusPublished
ror.fileinfo12143337980001831 13143337330001831 9916105309901831_53140318720001831.pdf
ror.mmsid9916105309901831

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