Care in Labour

Abstract

The Democratic Republic of Congo [D R Congo] has among the highest maternal and infant mortality rates in the world. Though a lot of positive changes have been made in the country when it comes to women’s health and maternity services, there still is a lot to be done to meet up with the WHO: s goals and to achieve an evidence based and efficient quality of care. The aim of this study is to describe how birth is managed in two maternity clinics in eastern D R Congo. The study has a focus on normal birth. Birth is profoundly a natural physiological process but this process can easily be disrupted. Medical interventions are developed for the few occasions when birth becomes pathologic and requires assistance and are not meant to interfere within the normal process. The study has a quantitative approach, and a descriptive analyze was used. The study was implemented during a time period of five weeks. Participating midwives, nurses and physicians at the maternity clinics completed a questionnaire after every delivery, concerning the management of intrapartum care. A part of the questionnaire is based on the evaluation tool called Bologna score. The management of labour at the two maternity clinics is according the Bologna Score not based on the best available evidence. All of the women gave birth in a supine position and the presence of a companion was not allowed. Episiotomies were performed in a high frequency, especially in primigravida. The finding in this study indicates that some changes in routines, management and attitudes need to be done at the maternity clinics, in order to achieve a high quality in intrapartum care.