Exploring Nigerian obstetricians’ perspectives on maternal birthing positions and perineal trauma

Hdl Handle:
http://hdl.handle.net/10034/618422
Title:
Exploring Nigerian obstetricians’ perspectives on maternal birthing positions and perineal trauma
Authors:
Diorgu, Faith; Steen, Mary; Keeling, June J. ( 0000-0002-8616-3614 ) ; Mason-Whitehead, Elizabeth
Abstract:
Abstract Background. Evidence recommends encouraging expectant mothers to adopt birthing positions that will assist them in having a normal physiological birth. Upright birthing positions have been shown to have good birth outcomes and assist women to give birth normally. However, adopting the lithotomy position with legs flexed and supported with hands has become an entrenched clinical birthing practice in Nigeria and is associated with an increased risk of a routinely performed episiotomy. Hospital protocols have supported this medicalised approach to how women give birth, with little regard to woman-centred care. Nevertheless, Nigerian obstetricians’ perceptions and experiences on birthing position and perineal trauma have received minimal recognition and research. Aim. To explore perceptions and experiences of Nigerian obstetricians regarding maternal birthing position and perineal trauma following childbirth, and to gain insights as to whether obstetricians’ clinical decisions and practice were influenced by evidence. Methods. A descriptive qualitative study was conducted involving a purposive sample of eight obstetricians recruited from two referral hospitals in the Niger Delta region of Nigeria during November 2014. Data were collected using an interview schedule and a thematic analysis was undertaken. Data analysis was guided by Braun and Clarke’s (2006) six-stage thematic framework. Interviews were transcribed in full and categorisation of the data achieved with several in-depth readings of the transcripts. Data saturation was reached with the facilitation of the second focus group interview as no more emerging themes were identified. The study obtained ethical approval from the health and social research ethics committee at the University of Chester in the UK, and also from the study hospitals in the Niger Delta region in Nigeria. Results. Six participants were doctors undertaking obstetric specialist training and two were consultant obstetricians. The following core themes emerged: entrenched practice, lack of insight for evidence, embracing woman-centred care and professional dominance. An overall finding demonstrated a willingness to support mothers in their choices of birthing position and involved reflections on the indications for an episiotomy and incidences of perineal injuries. The findings also indicated that the obstetricians were prepared to consider woman-centred care in relation to birthing position and perineal trauma. Conclusions. This study has enabled some Nigerian obstetricians to reflect upon their perceptions and experiences of their clinical decisions and practices concerning birthing position and perineal trauma. Their current practice was frequently not supported by evidence. However, it emerged that there was a willingness to listen to women and adopt clinical birthing practices and perineal care that would respect choices based on contemporary evidence. Adopting a woman-centred approach would also enable Nigerian midwives working in the two study hospitals to support women to give birth in a position of their choosing and reduce the risk of a routinely performed episiotomy
Affiliation:
University of Chester
Citation:
Diorgu, F., Steen, M., Keeling, J., & Mason-Whitehead, E. (2016). Exploring Nigerian obstetricians’ perspectives on maternal birthing positions and perineal trauma. Evidence Based Midwifery, 14(2), 64-70.
Publisher:
Royal College of Midwives
Journal:
Evidence Based Midwifery
Publication Date:
Jun-2016
URI:
http://hdl.handle.net/10034/618422
Additional Links:
https://www.rcm.org.uk/ebm
Type:
Article
Language:
en
Description:
This document is a published work that appeared in final form in Evidence Based Midwifery. To access the final edited and published work see https://www.rcm.org.uk/ebm
EISSN:
1479-4489
Appears in Collections:
Health and Social Care

Full metadata record

DC FieldValue Language
dc.contributor.authorDiorgu, Faithen
dc.contributor.authorSteen, Maryen
dc.contributor.authorKeeling, June J.en
dc.contributor.authorMason-Whitehead, Elizabethen
dc.date.accessioned2016-08-16T10:27:27Z-
dc.date.available2016-08-16T10:27:27Z-
dc.date.issued2016-06-
dc.identifier.citationDiorgu, F., Steen, M., Keeling, J., & Mason-Whitehead, E. (2016). Exploring Nigerian obstetricians’ perspectives on maternal birthing positions and perineal trauma. Evidence Based Midwifery, 14(2), 64-70.en
dc.identifier.urihttp://hdl.handle.net/10034/618422-
dc.descriptionThis document is a published work that appeared in final form in Evidence Based Midwifery. To access the final edited and published work see https://www.rcm.org.uk/ebm-
dc.description.abstractAbstract Background. Evidence recommends encouraging expectant mothers to adopt birthing positions that will assist them in having a normal physiological birth. Upright birthing positions have been shown to have good birth outcomes and assist women to give birth normally. However, adopting the lithotomy position with legs flexed and supported with hands has become an entrenched clinical birthing practice in Nigeria and is associated with an increased risk of a routinely performed episiotomy. Hospital protocols have supported this medicalised approach to how women give birth, with little regard to woman-centred care. Nevertheless, Nigerian obstetricians’ perceptions and experiences on birthing position and perineal trauma have received minimal recognition and research. Aim. To explore perceptions and experiences of Nigerian obstetricians regarding maternal birthing position and perineal trauma following childbirth, and to gain insights as to whether obstetricians’ clinical decisions and practice were influenced by evidence. Methods. A descriptive qualitative study was conducted involving a purposive sample of eight obstetricians recruited from two referral hospitals in the Niger Delta region of Nigeria during November 2014. Data were collected using an interview schedule and a thematic analysis was undertaken. Data analysis was guided by Braun and Clarke’s (2006) six-stage thematic framework. Interviews were transcribed in full and categorisation of the data achieved with several in-depth readings of the transcripts. Data saturation was reached with the facilitation of the second focus group interview as no more emerging themes were identified. The study obtained ethical approval from the health and social research ethics committee at the University of Chester in the UK, and also from the study hospitals in the Niger Delta region in Nigeria. Results. Six participants were doctors undertaking obstetric specialist training and two were consultant obstetricians. The following core themes emerged: entrenched practice, lack of insight for evidence, embracing woman-centred care and professional dominance. An overall finding demonstrated a willingness to support mothers in their choices of birthing position and involved reflections on the indications for an episiotomy and incidences of perineal injuries. The findings also indicated that the obstetricians were prepared to consider woman-centred care in relation to birthing position and perineal trauma. Conclusions. This study has enabled some Nigerian obstetricians to reflect upon their perceptions and experiences of their clinical decisions and practices concerning birthing position and perineal trauma. Their current practice was frequently not supported by evidence. However, it emerged that there was a willingness to listen to women and adopt clinical birthing practices and perineal care that would respect choices based on contemporary evidence. Adopting a woman-centred approach would also enable Nigerian midwives working in the two study hospitals to support women to give birth in a position of their choosing and reduce the risk of a routinely performed episiotomyen
dc.language.isoenen
dc.publisherRoyal College of Midwivesen
dc.relation.urlhttps://www.rcm.org.uk/ebmen
dc.subjectQualitative researchen
dc.subjectBirthing positionsen
dc.subjectBirthen
dc.subjectPerineal careen
dc.subjectPerineal injuryen
dc.subjectPerineal traumaen
dc.subjectEpisiotomyen
dc.subjectObstetricianen
dc.subjectEvidence-based midwiferyen
dc.subjectMidwife skillsen
dc.subjectMidwiferyen
dc.subjectMidwifery practiceen
dc.subjectMidwivesen
dc.subjectNigeriaen
dc.titleExploring Nigerian obstetricians’ perspectives on maternal birthing positions and perineal traumaen
dc.typeArticleen
dc.identifier.eissn1479-4489-
dc.contributor.departmentUniversity of Chesteren
dc.identifier.journalEvidence Based Midwiferyen
dc.date.accepted2016-05-20-
or.grant.openaccessYesen
rioxxterms.funderUnfundeden
rioxxterms.identifier.projectUnfundeden
rioxxterms.versionVoRen
rioxxterms.licenseref.startdate2016-09-16-
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