Impact of an educational intervention on postpartum perineal wound care among antenatal mothers in Jos: A quasi-experimental study

Abstract

Most women with stitched perineum after vaginal birth suffer some forms of postpartum complications. Pain is one of the distressing short term morbidity which interferes with the mother’s ability to carry out activities of daily living and care for her baby. Wound infection and dehiscence are usually seen in some cases. Supportive information on postpartum perineal wound care was given less attention during Antenatal health education sessions thereby making parturient unable to know and practice proper wound care that will aid healing. The aim of this study was to carry out an educational intervention then evaluate the impact of this intervention on practice of postpartum perineal wound care and wound healing. The design used for this study was quasi-experimental. A total of 200 mothers (100 interventions and 100 controls) were serially recruited purposively in antenatal Clinics. Instruments used for data collection consisted of a questionnaire and assessment tool. The instrument was reliable at Cronbach co-efficient alpha 78. Descriptive statistics such as frequency tables, percentages, bar chart, mean and standard deviations were used in analysis and Inferential statistics such as Chi-square and Pearson correlation were used in testing hypotheses. Participants in intervention group were given instructions on postpartum perineal wound care while those in control group received routine teaching on postpartum perineal wound care. The study lasted for 12 weeks. Findings indicate that mothers in intervention group on day 1 practiced perineal wound care; 91.88% implemented hygiene, 93.75% nutrition, 32.29% pain relief measures. On day seven, 92.50% practiced hygiene, 96.88% nutrition, 62.50% pain relief measures, 100% took their medications. Subjects in control group inadequately implemented the practice of postpartum self perineal wound care as seen in day 1; implementation of comfort measure was 3.3%, with 99.33% did not practice hygiene and none practiced eating food that prevents constipation but 99.67% adhered to their prescribed drugs because drugs are usually prescribed within 24 hours of delivery. Practice was found to influenced pain reduction in both group because as practice increased day 1 in intervention group, there was a decrease in pain intensity (r=-0.910; p<0.05) even though drugs are usually prescribed on discharge also, in control group as practice increased the second day, there was also decrease in pain intensity (r=-0.547; p=0.002). Women in the intervention group showed better wound healing process as 12.5% had severe pain on day 1 postpartum as against 20% in control group. On day 7 none in intervention group had gaped wound but 66.70% of them had gaped wound in control group. In conclusion, women who were taught postpartum perineal wound care practiced it and this resulted in better wound healing progress, therefore, it is recommended that postpartum self-perineal wound care be introduced to antenatal mother, guidelines on perineal wound care be made available in delivery centers, Midwives should encourage parturient to practice care while on admission and encourage mothers to practice care when discharged home.