Safe Childbirth Research Articles

Utilization and determinants of maternity waiting homes among pastoralist mothers in Dire district, southern Ethiopia: a mixed-methods study.

Maternity waiting homes are cost-effective, World Health Organization-approved components of comprehensive prenatal, delivery, and postpartum care strategies. However, few community-based studies within Ethiopia's pastoralist communities, and none in the study area, have been conducted to determine actual usage or to gain a thorough understanding of the factors influencing utilization. A cross-sectional study, supplemented by qualitative methods, was conducted from June 25 to July 25, 2023. A simple random sampling technique was used to select 305 study participants. Data were gathered through an interviewer-administered questionnaire, entered into Epi-data version 3.1, and analyzed using SPSS version 25. Descriptive data were presented in tables, graphs, text, and percentages. Bivariate logistic regression identified candidate predictors at a P-value of <0.25, and predictors of maternity waiting home utilization were identified through multivariate logistic regression at a 95% confidence interval and P-value of <0.05. Qualitative interviews were transcribed, translated, and thematically analyzed. The prevalence of maternity waiting home use in the study area was 35.2% (95% CI: 30.9%, 39.5%). Factors associated with maternity waiting home utilization included travel time greater than 60 min to nearby health facilities (AOR: 5.47 CI: 1.77, 16.91), good knowledge of danger signs of pregnancy (AOR: 5.41, CI: 1.86, 15.79), lack of a caretaker to household tasks (AOR: 0.1, CI: 0.03, 0.31), and a refusal to accept a waiting time of 2-4 weeks (AOR: 0.24 CI: 0.08, 0.74). The qualitative findings underscored hurdles such as resource constraints, challenges in providing maternity services, and the importance of community awareness and access to network connectivity in ensuring safe childbirth. This study aims to determine the utilization of maternity waiting homes and the factors associated with their use among women who gave birth within the last year in the Dire district, Borana zone, southern Ethiopia. The prevalence of maternity waiting home use was low compared to national efforts to promote this service. Longer travel time, lack of a caretaker, good knowledge of danger signs of pregnancy, and a refusal to accept a waiting time of 2-4 weeks were associated with maternity waiting home use in this study.

O PRÉ NATAL FRENTE A MORBIMORTALIDADE MATERNO INFANTIL

This study addresses the critical importance of prenatal care in reducing maternal and infant morbidity and mortality, highlighting the significance of early adherence by pregnant women to these services. Through a literature review, it was possible to identify complications associated with non-adherence to prenatal care, such as premature births, low birth weight, and the prevalence of gestational complications that can be mitigated with adequate and timely care. Among the effective strategies for the recruitment and retention of pregnant women, the role of nurses was emphasized as fundamental, utilizing techniques that include health education, the use of information technology, and interdisciplinary practices. Programs such as Rede Cegonha were also mentioned, highlighting their contribution to strengthening prenatal care, childbirth, and postpartum support. The study underscores the need for efficient public policies and ongoing research to improve prenatal services, ensuring that all pregnant women have access to effective and humane care, guaranteeing a healthy pregnancy and a safe childbirth. This work emphasizes the urgency of integrated and evidence-based approaches in prenatal care, aiming for significant improvements in maternal and infant health.

Iranian midwives’ experiences of using the World Health Organization’s Safe Childbirth Checklist: A qualitative research

BACKGROUND: The goal of natural childbirth care is to have a healthy mother and baby with minimal interventions that are contrary to health. Worldwide, there is concern that non-evidence-based interventions and care in labor and childbirth will remain standard practice. Therefore, access to care related to pregnancy and childbirth is considered a priority. To address safety concerns during organized births, the Safe Childbirth Checklist (SCC) was created by the World Health Organization (WHO). This checklist is a tool that combines evidence-based practices that should be provided before, during, and after childbirth. As midwives have a vital role in using this up-to-date evidence, this study was conducted to explore Iranian midwives’ perception of using SCC. MATERIALS AND METHOD: This qualitative study was conducted from January 2022 to April 2023 in two public (teaching and nonteaching) hospitals in Ahvaz, Iran. Seventeen semi-structured interviews were conducted with midwives who had more than one year of work experience in maternity wards. Participants were selected purposefully. A content analysis approach was used to analyze the data and extract themes. RESULTS: All midwives had a positive attitude toward using SCC. The midwives’ reasons for being in favor of using the checklist during the clinical procedures of childbirth are summarized in four main themes, namely “standardized maternity care practices,” “SCC as a guide for performing essential childbirth practices,” “self-efficacy of midwifery care,” and “improved maternal and neonatal outcomes.” CONCLUSION: Midwives have endorsed this checklist as a guide to standard childbirth management. It seems that the use of this checklist will help to improve the health outcomes of mothers and babies by strengthening the self-efficacy of midwives.

Investigate mothers’ perceptions and experiences of natural childbirth and quality of care in childbirth management based on Safe Childbirth Checklist: A qualitative study

Investigate mothers’ perceptions and experiences of natural childbirth and quality of care in childbirth management based on Safe Childbirth Checklist: A qualitative study

Myanmar immigrant women’s perceptions, beliefs, and information-seeking behaviors with nutrition and food practices during pregnancy in Thailand: a qualitative study

BackgroundAlthough nutrition is an essential contributor to the quality of pregnancy outcomes, little is known about the experiences and influences affecting dietary behaviors during pregnancy among migrant women, particularly those from Myanmar, the largest immigrant population in Thailand. To fill this gap, we conducted a descriptive qualitative study to explore Myanmar immigrant women’s perceptions, beliefs, and information-seeking behaviors concerning nutrition and food practices during pregnancy.MethodsWe conducted focus group discussions (FGDs) with fifty Myanmar immigrant pregnant women aged 18–45 years across all trimesters, who were recruited using purposive sampling from a public tertiary hospital. The FGDs were conducted in Thai or Myanmar using semi-structured guides that probed women’s pregnancy perceptions and experiences about nutrition and food patterns during pregnancy. The FGDs were audio-recorded, translated, and transcribed. Direct content analysis was used to guide the analysis through an ecological perspective framework.ResultsThe seven FGDs with fifty women revealed four major themes involving perceptions, beliefs, and information-seeking behaviors. The qualitative results consisted of (1) a positive attitude toward better changes under difficult conditions (setting goals for infant health; uncertainty about changes); (2) beliefs about eating patterns and dietary practices during pregnancy (taboos aimed at protecting women’s health and ensuring safe childbirth; taboos aimed at guaranteeing infant safety); (3) limited access to appropriate information about nutrition (unclear dietary information from healthcare providers; ease of learning from experiences in informal social networks); and (4) difficult living conditions in a non-native setting (work-related influences on dietary behaviors; lack of comprehensible language to gain food literacy). In addition, the results were highlighted across four levels of ecological perspectives.ConclusionsImmigrant pregnant women are a vulnerable population that should be treated with equity to ensure quality of life through optimal nutrition throughout pregnancy. Respectful care requires that healthcare providers develop culturally sensitive nutrition interventions to increase nutrition literacy, accessibility, and pregnancy outcomes.

Antenatal Care Visits, Institutional Births, and Associated Risk Factors in Afghanistan: Insights from the Multiple Indicator Cluster Survey 2022-2023.

Insufficient use of antenatal care (ANC) services and institutional births services can elevate the maternal mortality risk in limited resource settings. Hence, the key objective of this study was to evaluate the potential association between the frequency of ANC visits and institutional birth services in Afghanistan, while also identifying other sociodemographic factors that may exert influence. Furthermore, we explored factors associated with the attendance of women at ANC visits during their pregnancy. We employed data from the most recent Multiple Indicator Cluster Survey conducted in Afghanistan in 2022 to 2023 with a total of 8096 women aged 15 to 49. A complex survey weight-adjusted logistic regression model was used to examine factors related to institutional births, and a multinomial logistic regression model was fitted to assess the relationships between sociodemographic factors and ANC visits, adjusting for survey weights, cluster effects, and strata. Approximately 40% of the sample (n = 3247) had undergone 4 or more ANC visits, and 74.4% (n = 6,022) had opted for institutional birth. Women's higher education was found to be associated with ANC visits. The area of residence, wealth index, education levels of women, ownership of mobile phones, number of children, and number of ANC visits were associated with institutional births. Compared with women with no or one ANC visit, those with more than 3 visits had 31% higher odds (adjusted odds ratio, 1.31; 95% CI, 1.10-1.57) of accessing institutional births. Our findings indicate a significant association between ANC visits and use of institutional birth care. These findings carry implications for advancing safe motherhood and childbirth by enhancing women's social status.

Counseling on The Implementation of Gymnastics for Pregnant Women in Undergoing a Healthy Pregnancy and Readiness for Normal Childbirth For Pregnant Women

The health of pregnant women is still one of the indicators of how to achieve the degree of public health in Indonesia. Pregnant women who have a healthy and comfortable pregnancy will of course have an impact on safe childbirth and also the baby born will be healthier, to realize this, pregnant gymnastics can be done for pregnant women because it can have a real health impact felt on the mother during pregnancy and even until childbirth. The purpose of this community service is to strive for pregnant women to be able to have a healthy pregnancy and prepare the mother's body to give birth safely and smoothly. Other goals of pregnancy gymnastics are Achieving optimal relaxation during pregnancy until childbirth both physically and psychologically, Achieving the adequacy of the pelvic floor muscles when straining, Preparing the pregnant woman mentally and physically and Achieving physiological, natural, comfortable childbirth, with the mother and her baby. The implementation of this community service activity was carried out at the Cahaya 2 Sekip Clinic, for one day on March 23, 2024 with a total of 24 respondents of pregnant women whose gestational age is in the second trimester and third trimester of pregnancy. The implementation also consists of the stage of collecting data on pregnant women, determining the time of activities, initial examination of pregnant women, counseling activities in the form of education about pregnancy gymnastics and the last stage, namely the implementation of pregnancy gymnastics activities. As a result of this activity, almost all pregnant women do pregnancy gymnastics well, besides that pregnant women are also very enthusiastic and happy with the pregnancy gymnastics activity because repondents can share with extension workers and other participants and especially pregnant gymnastics has many benefits for mothers during pregnancy.

Which type of forceps is better for nonrotational operative births? A simulation study comparing Thierry spatulas and Simpson-Braun and Kielland forceps.

Obstetric forceps play an important role in safe childbirth, yet there is a lack of distinction between various forceps types in clinical practice. This study aimed to evaluate and compare perineal pressure and forces on the baby during nonrotational forceps-assisted births using Simpson-Braun forceps, Kielland forceps, and Thierry spatulas on a simulation model. This experimental study involved six obstetricians conducting 108 forceps-assisted births on a simulation model. Instruments were assessed for their impact on perineal pressure, traction force, and operator-assessed difficulty. Thierry's spatulas exerted the lowest force on the baby, while Kielland forceps exhibited the lowest perineal pressure, though not statistically significant. An experienced obstetrician demonstrated less perineal pressure with Simpson forceps. Notably, no significant differences in difficulty were observed between instruments. This study highlights distinctions in forceps performance, with Thierry spatulas applying the least force on the fetal head, while an experienced obstetrician fared better with Simpson forceps in terms of perineal pressure. Kielland forceps remain a viable alternative for nonrotational forceps births, showing comparable outcomes.

Exploring the Drivers of Home Births: Perspectives, Risks, Benefits, and Policy Implications in Zamboanga Sibugay, Philippines

Background: The persistence of home births in the Philippines remains conspicuous, despite the enforcement of policies discouraging this practice and the prevailing concerns about its safety. This research aims to delve into the various perspectives of women concerning home births to describe the underlying motivations behind their choices, their perceptions of the associated risks and benefits, and their stance on the “no home-birthing policy” of the state. Subjects and Method: This was a descriptive, cross-sectional study involving 80 mothers drawn from Malangas, Zamboanga Sibugay, Philippines through a referral-based sampling method. The study examined sociodemographic characteristics as independent variables, while dependent variables included perceived reasons for home birth preference, associated risks and benefits, and respondents' views on the "no home-birthing" policy. Data were described in descriptive statistics. Results: The findings showed that the inclination of women toward giving birth at home without the presence of professional birth attendants emanates from a multitude of factors. These include economic considerations, the sense of a familiar and comfortable environment, deeply rooted cultural beliefs, challenges related to accessibility to health facilities, and geographical impediments. Notwithstanding the inherent health risks, women opt for home births due to cost considerations, improved accessibility, and as a means of expressing their cultural and personal convictions. Consequently, the "no home-birthing policy" implemented in the Philippines is seen to reflect an effort to safeguard maternal and neonatal health by promoting facility-based deliveries. Conclusion: The study underscores the importance of developing a holistic healthcare strategy that harmonizes women's autonomy and cultural practices with the crucial goal of ensuring safe childbirth, especially in marginalized areas.

Implementation of the WHO Safe Childbirth Checklist: a scoping review protocol

IntroductionThe WHO Safe Childbirth Checklist (WHO SCC) was developed to accelerate adoption of essential practices that prevent maternal and neonatal morbidity and mortality during childbirth. This study aims to summarise...

Pregnant racialised migrants and the ubiquitous border: The hostile environment as a technology of stratified reproduction.

This article explores the impact of the 'hostile environment' on racialised migrant women's experiences of pregnancy and childbirth in England, arguing that the 'hostile environment' functions as a technology of 'stratified reproduction.' First coined by Shellee Colen, the concept of stratified reproduction describes the dynamic by which some individuals and groups may be supported in their reproductive activities, while others are disempowered and discouraged. This paper locates the stratified reproduction produced by the 'hostile environment' as intertwined with wider gendered and racialised discourses around British citizenship which have been 'designed to fail' racialised residents of the UK. Drawing on interviews with racialised migrant mothers in the north of England, this paper analyses how the proliferation and intensification of immigration controls interacts with gender, race, class, and other social regimes to differentially allocate the resources necessary for a safe and healthy pregnancy and childbirth, and how this is experienced materially by pregnant migrants.

Awareness and Use of World Health Organisation Safe Childbirth Checklist among Midwives Practicing in Health Institutions in Imo State

Maternal and child health are pivotal to the growth and development of any nation and a critical aspect of the healthcare practice that ensures that adequate and safe childbirth practices are in place for safe delivery especially in resource-constrained settings. This study determined the awareness, use, benefits and challenges with the WHO Safe Childbirth Checklist among the Midwives in Imo State, Nigeria. The study utilized a descriptive survey design and surveyed 145 midwives as a sample. Data was collected from both primary and secondary sources. For the quantitative data, a well-structured questionnaire was issued to midwives employed by certain health facilities in Imo state. The midwives were selected using a random sampling method. Both descriptive and inferential statistics were conducted, and results were presented in the form of tables, charts, and percentages. More of the respondents were 36 years or older (74.5%), spent greater than 10 years in practice (57.9%), are graduates (75.9%), work in the public health facilities (64.1%). only 27.6% of the midwives working in these facilities are aware of the WHO Childbirth Checklist and only 4.8% of them consistently incorporate the checklist in their routine care of women in labour. Staff with more than 10 years of experience (p = 0.021), involved in teaching/administration (p = 0.007), as well as those without professional memberships (p&lt;0.001) were significantly associated with consistent use of the WHO Checklist. The study's findings add to the existing body of knowledge and provide valuable insights into the awareness and utilization of the WHO SCC among midwives in the Imo State. This, in turn, sheds light on potential areas for improvement in maternal delivery.

Healthcare providers factors influencing the uptake of WHO modified safe child birth checklist in management of pre-term births among healthcare workers in Migori County, Kenya

Background: The World Health Organization introduced the safe childbirth checklist in 2015 to address high rates of maternal mortality and preterm deliveries. The checklist varies based on geography and socioeconomic position. Healthcare professionals in developing nations lag behind those in developed nations, with less than sixty percent using the checklist routinely in African nations. Methods: Analytical cross-sectional study design was used and 140 participants in the selected public health facilities in Migori County, Kenya. Data was collected using administered structured questionnaire, and Key Informant Interview. Quantitative data analysis was conducted using SPSS version 26.0 and involved univariate and bivariate analysis. Bivariate analysis was done through logistic regression was used to test the significance of the association between the dependent and independent variables (p&lt;0.05). Qualitative data was analyzed by thematic content analysis. Results: Almost three-quarter of respondents 100 (71.4%) use the WHO safe childbirth checklist, with 80 (78.4%) of nursing officers and 22 (75.9%) of respondents aged between 40-49 years had higher uptake of WHO modified safe childbirth checklist. Cadre (ꭓ2=9.030; df 1; p=0.003), understanding what mSCCL is all about (p=0.0001), aware mSCCL is available in maternity unit (p=0.0001), and understanding the pause points in the mSCCL (p=0.006) were significantly associated with uptake of WHO modified safe childbirth checklist. Conclusions: Healthcare institutions should prioritize comprehensive training programs on the mSCCL, incorporating peer-led initiatives and experienced healthcare workers for practical insights and shared experiences.

The relationship between Iranian women’s perception of their birth team’s compliance with medical ethics and their perception of labor pain

BackgroundA safe and satisfactory childbirth experience with the least amount of pain constitutes one of the main domains of reproductive healthcare. The most important aspect of labor pain management is the moral and professional commitment of the health professionals and caregivers involved in creating a pleasant delivery. The present study examines the relationship between Iranian women’s perceptions of their birth team’s compliance with medical ethics and their perception of labor pain.MethodsThis cross-sectional study was conducted on 200 women opting for natural childbirth. The samples were selected by convenience sampling. Three questionnaires, including a demographic information questionnaire, the perception of labor pain questionnaire, and the medical ethics attitude in vaginal delivery questionnaire, were used to collect data. The data were entered into SPSS 22 and analyzed using correlation coefficient and multiple regression tests. The significance level for data analysis was set as less than 0.05.ResultsThe results of the regression analysis showed that among the four principles of medical ethics, only the second and third principles (beneficence and non-maleficence) predicted the perception of labor pain (B = -0.267, P < 0.037). Among the different domains of these principles, the areas of giving the necessary information to the mother (B = -0.199, P = 0.001), respecting the mother’s privacy (B = -0.194, P = 0.001), interaction with the mother (B = -0.287, P = 0.001) and assurance of fetal health (B = -0.492, P = 0.001) were predictors of labor pain perception score.ConclusionsCompliance of the birth team with respecting the mother’s privacy, having friendly interactions with the mother and giving fetal health assurance to the mother can be a predictor of the mother’s decreased perception of labor pain.

A arte de endurecer sem perder a ternura: o uso de tecnologias por obstetrizes na atenção ao parto domiciliar planejado

Abstract Introduction: Given the intense medicalization of childbirth and the hegemony of a technocratic model, there is a growing need for professional midwives to promote safe pregnancy and childbirth with minimal interventions. Objective: This study aims to identify the technologies present in the toolbox of certified midwives graduated from University of São Paulo. Methodology: It consists of a descriptive-exploratory study, with a qualitative approach. Semi-structured interviews were carried out virtually with five midwives from August 2020 to May 2021. The material was analyzed using dialogical maps. Results: A very heterogeneous range of technologies was identified, which included soft, soft-hard, and hard technologies. Soft technologies include affection, effective communication (knowing how to speak, knowing how to listen), and bonding. Soft-hard technologies include basic disciplines, scientific evidence, experience, and intuition. Finally, hard technologies include human-made instruments, in addition to the use of the materiality of the body. Conclusions: Midwives tend to use hard technologies when they are unable to achieve the desired effect with the soft technologies they had available, while also using their interrelational resources throughout the entire process. Furthermore, to employ such technological resources, professionals use different kinds of knowledge, without hierarchizing them.

Statistical exploration and projection of SDG-3 in Bangladesh through DHS: a study on data-driven perspectives using logistic regression

Sustainable Development Goal-3, as defined by the United Nations, aims to ensure healthy lives, and promote well-being for all at all ages. In the context of Bangladesh, achieving the targets of SDG-3 is a critical priority for public health and development. This study presents a data-driven exploration of SDG-3 in Bangladesh, focusing on maternal and child health indicators. We utilized data from multiple Bangladesh Demographic and Health Surveys conducted in 2011, 2014, and 2018 to provide a comprehensive analysis of health-related trends and determinants. We employed rigorous statistical techniques, including backward stepwise logistic regression and Pearson correlation coefficients, to uncover insights into the status of maternal and child health in Bangladesh. The prevalence of safe childbirth practices exhibited a gradual improvement from 2011 (32.5%) to 2018 (50.2%). Notably, women with higher levels of education demonstrated a significantly higher likelihood of safe childbirth practices (odd ratio = 1.73, 95% Confidence Interval: 1.19 – 1.97). Additionally, residing in urban regions (odd ratio = 1.07, 95% Confidence Interval: 0.96 – 1.39), having access to mass media (odd ratio = 1.34, 95% Confidence Interval: 0.98 – 1.41), receiving antenatal care (odd ratio = 1.62, 95% Confidence Interval: 1.16 – 1.92), being in the rich wealth index category (odd ratio = 1.13, 95% Confidence Interval: 0.92 – 1.39), and choosing to deliver outside the home (odd ratio = 1.48, 95% Confidence Interval: 1.11 – 1.86) were all associated with a higher likelihood of safe childbirth practices. The findings from this study show the power of data-driven decision-making in shaping health policies and interventions. They reveal critical factors affecting health outcomes, offering a roadmap for policymakers and stakeholders to design evidence-based strategies for improving maternal and child health in Bangladesh. This proposed work not only contributes to the academic understanding of public health in Bangladesh but also serves as a practical guide for those working to achieve SDG-3. As Bangladesh continues its journey toward health and well-being for all, this study sets a benchmark for evidence-based policymaking, emphasizing the importance of data-driven perspectives in the pursuit of SDG.

"Gentle Birth" To Prepare For Safe And Comfortable Childbirth For Pregnant Women At TPMB Desi Trianita, Lateng District, Banyuwangi

The phenomenon of childbirth from year to year with the increasing cesarean section method and increasingly sophisticated cesarean section methods has made the scope of midwifery services narrower. One method that is currently being developed is the Eracs method of delivery by cesarean section. Where with this method many pregnant women are tempted by the word "painless", many pregnant women with a fairly high percentage choose to deliver with this method without indications and without regard to the effects on the reproductive organs in the future. The aim is to carry out outreach to pregnant women about comfortable delivery in pregnant women with the "Gentle Birth" method. The results of this counseling are to increase pregnant women's knowledge about safe and comfortable childbirth, both normal and cesarean section. The counseling went well, in an orderly manner, and the pregnant women were very happy with the material provided, which can be seen from the enthusiasm of the mothers while participating in the counseling.

The Effect of Alarm Use on the Awareness of Taking Iron Supplements (Haemoglobin Levels) as a Prevention of Haemorrhagic Postpartum

Anemia is one of the indirect causes of Postpartum Hemorrhage (HPP) during childbirth. The development of iron supplement alarm reminders can be used as an alternative intervention to increase awareness and consumption of iron supplements as a preventive measure against HPP. This study aims to analyze the Effect of Alarm Usage on Awareness in Consuming Iron Supplements (Hemoglobin Levels) as a Prevention of HPP in the Working Area of the Tempurejo Community Health Center, Jember Regency. The research employs a one-group pre-post-test design (pre-experiment) with a cross-sectional approach involving 30 respondents through Accidental Sampling. Data collection includes coding, editing, tabulation, and subsequent manual and computer-based analysis using Paired T-Test. Among the 30 respondents, the awareness of taking iron supplements before using the alarm showed non-compliance in 22 respondents (73.3%) and compliance in only 8 respondents (26.7%), with all 30 (100%) pregnant women experiencing anemia, either moderate (73.3%) or mild (26.7%). After the alarm was used, the number of respondents aware and compliant in taking iron supplements increased to 27 respondents (90%), with only 3 respondents (10%) remaining non-compliant. This was also indicated by an increase in normal Hb levels in 18 respondents (60%). The P-value was 0.000 and a = 0.05, meaning r &lt; a, indicating the influence of alarm usage on awareness in consuming iron supplements (hemoglobin levels) as a preventive measure against HPP. This is crucial for pregnant women to regularly consume iron supplements for safe and healthy childbirth. Midwives should consistently remind pregnant women to consume a minimum of 90 supplements during pregnancy and adapt to technological advancements by using gadgets familiar to the community

Healthcare Workers’ Knowledge and Use of Safe Childbirth Checklist Tool in Tertiary Hospitals in Rivers State

Globally, maternal mortality is an indicator to monitor maternal health services. In 2010, the WHO indicated that maternal deaths in Nigeria contributed to 14% of global maternal deaths. In 2018 Nigeria’s maternal mortality rate was 512 deaths per 100,000 live births. The WHO and other key partners developed the Safe Childbirth Checklist (SCC) as a facility-based tool to serve as reminder to help health workers adhere to evidence-based practices to ensure safety of the mother and baby. SCC has reportedly been adopted for use in other countries like Brazil and Cameroon. The objective of this study was to assess the Doctors and Nurses’ Knowledge and Use of SCC in public tertiary hospitals in Rivers State. Descriptive cross-sectional study was used. Structured questionnaires were self-administered to 207 respondents (35 nurses and 67 doctors at RSUTH, 49 nurses and 56 doctors at UPTH) working in obstetrics and gynaecology department. Chi-square was used to test the hypothesis. Descriptive statistics was used to assess the responses of the respondents. Responses obtained at Teaching Hospital A showed that 80% of the Nurses/Midwives have no knowledge of SCC tool, 100% of the House Officers have not seen the tool; 90% of the Resident Doctors have not also used SCC tool. At Teaching Hospital B, 80% of the Nurses have no knowledge of SCC tool; 20% of the Nurses had seen it earlier. The study showed evidence that SCC tool is not in use in the two tertiary hospitals in Rivers State. Null hypothesis was accepted.

FIGO good practice recommendations for cesarean delivery: Prep-for-Labor triage to minimize risks and maximize favorable outcomes.

Cesarean delivery is an abdominal surgical procedure performed for child delivery when the vaginal route is not feasible or desired due to maternal/fetal indications. All childbirth facilities should be able to safely perform a cesarean, which is not the current reality. For planned cesarean delivery, the facility must be prepared for the patient. In contrast, for unplanned arrivals at the facility, FIGO's Prep-for-Labor triage method allows rapid decision-making on whether cesarean delivery can be safely performed on site or whether transfer to an advanced care center is needed. A checklist of staff/tools for safe on-site cesarean delivery is provided to enable timely decision-making. Maternal complications following cesarean are three-fold higher than vaginal delivery. To prevent nonmedically indicated cesarean by favoring vaginal delivery, up-to-date safe and effective guidance is provided, defining labor, second stage length, and status before an arrested labor is confirmed. Whether cesarean delivery is planned or emergency, the Misgav Ladach simplified procedure is proposed as it is suitable for both low- and high-risk cases, including twins, thereby reducing both operative morbidity and postoperative recovery. A trial of labor after first cesarean (TOLAC) should be pursued when feasible, for which the indications, contraindications, safeguards, and steps of safe labor induction are delineated. Implementation of these good practice recommendations will improve childbirth by reducing excessive nonindicated cesareans, while precisely defining the resources and postoperative care required for safe performance on site. Enabling safe childbirth by cesarean and TOLAC, even at sites with low rates currently, will significantly improve maternal and fetal outcomes.