Strategies to Improve Patient Care by Increasing Midwives' Knowledge of Postpartum Care


WellStar School of Nursing

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Objective Postpartum care is critical in preventing and reducing maternal deaths. In Ghana, midwives are the primary maternity care providers; therefore, their knowledge of postpartum care determines the quality of care provided to women after childbirth. However, few studies have examined midwives’ knowledge of postpartum care in sub-Saharan Africa. This study explores knowledge of postpartum care among midwives in order to develop interventions to improve patient care after childbirth. Design Cross-sectional survey. Setting Four hospitals in Tamale, Ghana. Patients/Participants A convenience sample of midwives, 18 years and older, employed in the four hospitals. Methods A cross-sectional survey of 246 midwives was conducted in the four main hospitals of Tamale, Ghana. Three of the hospitals were government facilities and one was a mission hospital. The study was guided by the Three Delays Framework, specifically focusing on Phase III delays of provision of adequate care at a health care facility. Data were collected using an anonymous postpartum-care knowledge questionnaire by the Johns Hopkins Program for International Education in Gynecology and Obstetrics. Data were analyzed in Stata statistical software using descriptive statistics. Results Most of the midwives were women (98%). The mean age of midwives was 31.87 years. About 40.4% had a certificate in midwifery, 46.9% had a diploma in midwifery, and 12.7% had a bachelor’s in midwifery. The percentage of midwives able to correctly answer each question are as follows: 41.63% on location of fundus, 46.53% on postpartum examination, 57.55% on care during the first 2 hours after birth, 62.04% on obtaining history during a postpartum visit, 67.67% on obtaining information on patient problems during a postpartum visit, 73.47% on timing of postpartum visits, 74.29% on infection-prevention practice, 75.92% on danger signs, 77.14% on breastfeeding, and 84.90% on nutrition for breastfeeding mother. Beside their midwife education, 42% of midwives had never received any continuing education or in-service training in postpartum care. Implications for Nursing Practice Findings suggest that the majority of midwives are not knowledgeable about location of fundus, postpartum examination, and care during the first 2 hours after birth. However, most midwives are knowledgeable about breastfeeding. Findings suggest a need for refresher training to educate midwives on how to care for postpartum patients.

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Journal of Obstetric, Gynecologic & Neonatal Nursing

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