Measuring the importance of labour support practice for mothers and nurses and midwives at public health facilities in Rwanda

Abstract

Background: The need to support women during labour and delivery at health facilities is important for a positive birth experience and for improving the quality of maternal and neonatal care. Provision of labour support offered by nurses and midwives assist labouring women to cope with the process of childbirth. Little is known about the provision and the measurement of labour support practices in developing countries including Rwanda. Aim: The aim of this study is to establish the current state of the importance of labour support practices for mothers and nurses and midwives at public health facilities in Rwanda. Methodology: A descriptive quantitative and cross-sectional design was employed in this study. The study began with a scoping review followed by the development of a labour support tool, then a survey was conducted using the labour support questionnaire with closed and open-ended questions among 648 women in postnatal wards and 154 nurses and midwives working in labour and delivery wards at public health facilities located in Kigali City, Rwanda. Findings: Best practices of labour support including emotional support, physical support, information and advice and advocacy are implemented in developing countries. The quantitative data revealed that most nurses and midwives were relatively young (<40 years old). Most mothers had only obtained a primary level of education. Nurses and midwives and mothers valued and ranked high the importance of professional support and communication during the childbirth process. Both participant groups ranked the comfort and emotional support as less important. Mothers with primary education attributed a low ranking to the importance of professional support. The majority of nurses and midwives who had spent more than 10 years in labour and delivery wards indicated a limited importance for comfort support. Mothers and nurses and midwives reported that limited infrastructure, shortage of staff and equipment and a lack of awareness of labour support influenced negatively the implementation of labour support practices. Conclusion: Though nurses, midwives and mothers value and rank highly the importance of professional support and communication during the childbirth process, the effective implementation of labour support practice is often challenged by constrained resources. The recommendations are formulated with regard to nursing practice, management, education, research and policy.