Midwives' experiences and perceptions on the use of the Labour Care Guide: A qualitative study

Over one-third of maternal deaths, nearly half of stillbirths, and a quarter of neonatal deaths are attributed to complications during labour and childbirth. Currently, the Labour Care Guide (LCG) is the only tool that promotes the implementation of the World Health Organization's recommendations on intrapartum care, ensuring a positive childbirth experience. Previous studies examining midwives' experiences in utilising the LCG did not include Namibia, hence this study.

This study aimed to explore and describe midwives' experiences and perceptions of using the LCG at a training hospital in Namibia.

An exploratory descriptive qualitative design was employed to collect data from 10 midwives between May 2023 and July 2023. The interviews were audio-recorded, transcribed, and analysed using inductive reflective thematic analysis. The study adhered to the Consolidated Criteria for Reporting Qualitative Research reporting guideline.

The study identified three themes: LCG optimisation challenges, perceived usefulness of LCG and suggestions for improvement. While midwives expressed overall satisfaction with the new components of the LCG, some midwives perceived a shortcoming with regard to monitoring and managing labour progress in mothers who consumed traditional oxytocin known as Sivatu as being at risk for uterine rupture, foetal distress, or even death. The lack of resources and cultural norms on labour companionship poses LCG implementation challenges.

This study found that while some midwives embraced the use of the LCG for monitoring labour and identifying abnormalities and complications, others perceived a limitation pertaining to monitoring women using traditional oxytocin.Contribution: The study thus recommends exploring alternative methods and strategies for safe labour monitoring and management.