Evaluating the content and quality of intrapartum care in vaginal births: An example of a state hospital.

Zekiye Karaçam,Döndü Arslan Kurnaz,Gizem Güneş

doi:10.4274/tjod.88123

Zekiye Karaçam, Döndü Arslan Kurnaz + Show 1 more

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https://doi.org/10.4274/tjod.88123

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Abstract

Objective:The purpose of the research was to assess the content and quality of the intrapartum care offered in vaginal births in Turkey, based on the example of a state hospital.Materials and Methods:This cross-sectional study was conducted between January 1st, 2013 and December 31st, 2014 at Aydın Maternity and Children’s Hospital. The study sample consisted of 303 women giving vaginal birth, who were recruited into the study using the method of convenience sampling. Research data were collected with a questionnaire created by the researchers and assessed using the Bologna score. Numbers and percentages were assessed in the data analysis.Results:The mean age of the women was 25.14±5.37 years and 40.5% had given one live birth. Of the women, 45.2% were admitted to hospital in the latent phase, 76.6% were administered an enema, 3.3% had epidural anesthesia, 2.6% delivered using vacuum extraction, and 54.1% underwent an episiotomy. Some 23.8% of the women experienced spontaneous laceration that needed sutures. The babies of two women exhibited an Apgar score below 7 in the fifth minute. When the quality of the intrapartum care given to the women was assessed with the Bologna score, it was found that 92.7% went into labor spontaneously, 100% of the births were supervised by midwives and doctors, 97.7% of the women had no supporting companion, and the nonsupine position was only used in 0.3% of the women. A partogram was used to follow up on the birth process in 72.6% of the women, and 82.5% achieved contact with their babies within the first hour after birth. Induction was applied in 76.6% of the women and fundal pressure in 27.4%.Conclusion:The study revealed that the quality of intrapartum care in vaginal births was inadequate. Reformulating the guidelines regarding intrapartum care in accordance with World Health Organization recommendations and evidence-based practices may contribute to improving mother and infant health.

Highlights

The high birth rate and percentages of maternal and infant deaths in Turkey continue to occupy a priority as major health issues
When the quality of the intrapartum care given to the women was assessed with the Bologna score, it was found that 92.7% went into labor spontaneously, 100% of the births were supervised by midwives and doctors, 97.7% of the women had no supporting companion, and the nonsupine position was only used in 0.3% of the women
Some 45.2% (n=137) of the women were admitted to hospital with a cervical dilation of 1-3 cm, 76.6% (n=232) were administered enemas, 3.3% (n=10) had epidural anesthesia, vacuum extraction was performed on 2.6% (n=8), and an episiotomy was performed on 54.1% (n=164)

Summary

Introduction

The high birth rate and percentages of maternal and infant deaths in Turkey continue to occupy a priority as major health issues. In the effort to end preventable maternal and infant mortality and morbidity, it is stressed that every pregnant woman and newborn needs to receive evidence-based basic care from well-trained healthcare professionals and to have this in a supportive environment[4]. From another perspective, research points to the probable association between intrapartum care practices and the rise in cesarean rates, so it is important to avoid elective induction practices and to maintain professional teamwork if cesarean rates are to be reduced[7]. The purpose of this research was to assess the content and quality of intrapartum care offered in vaginal births in Turkey, based on the example of a state hospital and using the Bologna score

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Conclusion