Midwives' experiences of providing pre-eclampsia care in a low- and middle-income country - A qualitative study.

Experiences Low- and middle-income country Midwifery Midwives Pre-eclampsia Qualitative

Journal

Women and birth : journal of the Australian College of Midwives
ISSN: 1878-1799
Titre abrégé: Women Birth
Pays: Netherlands
ID NLM: 101266131

Informations de publication

Date de publication:
16 Nov 2023
Historique:
received: 17 07 2023
revised: 12 10 2023
accepted: 06 11 2023
medline: 18 11 2023
pubmed: 18 11 2023
entrez: 17 11 2023
Statut: aheadofprint

Résumé

Like other low- and middle-income countries, Ghana has high maternal mortality stemming from pre-eclampsia. Ghanaian midwives are frontline service providers of emergency care in obstetric complications and have the greatest potential to maximise pre-eclampsia outcomes. Little is known about the potential barriers and challenges to midwives' capacity to provide quality care in pre-eclampsia in Ghana. Therefore, we aimed to explore and gain insights into midwives' experiences of pre-eclampsia care including their knowledge, skills, and psychological aspects such as midwives' resilience. There is a rising global incidence of pre-eclampsia. Quality midwifery care in inter-professional collaborative practice is crucial to reducing pre-eclampsia-related morbidity and mortality. A qualitative descriptive exploratory study. In-depth semi-structured interviews (n = 35) were performed in 2021 and analysed by thematic analysis. There were three main themes. 1) Competence and Confidence in care; midwives provided timely and appropriate care based on sound knowledge and skills; they explained how pre-eclampsia care was organised within a multidisciplinary context and described collaborative working amongst midwives for mutual learning and support. 2) Emotional concerns and empathy; midwives' described fulfillment in achieving positive pre-eclampsia outcomes. In contrast, maternal loss was distressing and traumatic. 3) Call for improved care resources for pre-eclampsia; midwives recommended expansion of continuing professional development opportunities, appropriate infrastructure, resources, tailored public education, and a review of pre-service education to support their participation in pre-eclampsia care. To improve the quality of care in pre-eclampsia, midwives should be capacitated, systems should promptly address barriers, and prioritise midwives' emotional well-being.

Sections du résumé

PROBLEM OBJECTIVE
Like other low- and middle-income countries, Ghana has high maternal mortality stemming from pre-eclampsia. Ghanaian midwives are frontline service providers of emergency care in obstetric complications and have the greatest potential to maximise pre-eclampsia outcomes. Little is known about the potential barriers and challenges to midwives' capacity to provide quality care in pre-eclampsia in Ghana. Therefore, we aimed to explore and gain insights into midwives' experiences of pre-eclampsia care including their knowledge, skills, and psychological aspects such as midwives' resilience.
BACKGROUND BACKGROUND
There is a rising global incidence of pre-eclampsia. Quality midwifery care in inter-professional collaborative practice is crucial to reducing pre-eclampsia-related morbidity and mortality.
METHODS METHODS
A qualitative descriptive exploratory study. In-depth semi-structured interviews (n = 35) were performed in 2021 and analysed by thematic analysis.
FINDINGS RESULTS
There were three main themes. 1) Competence and Confidence in care; midwives provided timely and appropriate care based on sound knowledge and skills; they explained how pre-eclampsia care was organised within a multidisciplinary context and described collaborative working amongst midwives for mutual learning and support. 2) Emotional concerns and empathy; midwives' described fulfillment in achieving positive pre-eclampsia outcomes. In contrast, maternal loss was distressing and traumatic. 3) Call for improved care resources for pre-eclampsia; midwives recommended expansion of continuing professional development opportunities, appropriate infrastructure, resources, tailored public education, and a review of pre-service education to support their participation in pre-eclampsia care.
CONCLUSION CONCLUSIONS
To improve the quality of care in pre-eclampsia, midwives should be capacitated, systems should promptly address barriers, and prioritise midwives' emotional well-being.

Identifiants

pubmed: 37977957
pii: S1871-5192(23)00304-9
doi: 10.1016/j.wombi.2023.11.001
pii:
doi:

Types de publication

Journal Article

Langues

eng

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None.

Auteurs

Isabella Garti (I)

Faculty of Health, Charles Darwin University, Darwin, Australia. Electronic address: Isabella.garti@cdu.edu.au.

Michelle Gray (M)

School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia.

Angela Bromley (A)

Faculty of Health, Charles Darwin University, Darwin, Australia.

Jing-Yu Benjamin Tan (JB)

Faculty of Health, Charles Darwin University, Darwin, Australia; School of Nursing and Midwifery, University of Southern Queensland, Ipswich Campus, Ipswich, QLD 4305, Australia.

Classifications MeSH