Search

Because social support persons are excluded from modern obstetric care in Zambia, the aim of this study was to explore the views of 84 mothers and 40 health staff about allowing women to be attended by a supportive companion during labor in Zambian urban and rural maternities. Most of the mothers wanted a companion present to provide emotional and practical support. Those who were opposed to the idea had nobody to ask to be with them, or they had relatives who would interfere with the care provided. All health staff cited hospital policy as the principal reason for prohibiting social support persons from staying with laboring women. They also said that the health staff's role is to care for laboring women, and they worried that social support persons could interfere with their work by giving the laboring women traditional medicine. However, most health staff also said that a social support person could help the laboring women and give her a sense of security. The study concludes that Zambian maternity staff should be exposed to new research findings about the benefits of social support during childbirth and that this practice should be encouraged in Zambia. Ultimately, it should be the laboring woman who decides whether she wants to bring a social support person to the labor ward. [ABSTRACT FROM AUTHOR]

Objective: To describe the routine care of women during normal labour and delivery, and the immediate care of newborn babies in Zambia at different levels of health care., Design: A descriptive survey carried out between July 1994 and January 1995., Setting: Eleven maternity facilities, one University teaching hospital, two urban health centres and eight rural hospitals in one province in Zambia., Participants: Eighty-four women in normal childbirth and their babies studied from admission to the labour ward until time of discharge from the labour ward., Measurements and Findings: Observations related to the care of the women during normal labour and delivery, and the immediate care of the baby. The findings show that women were confined to bed during the whole labour and delivery period, food and drinks were withheld, and no gowns were provided. None of the women were allowed to have a companion present during labour. Fetal monitoring was inconsistent and the partograph was either not used or partly lacking. All women were delivered in a lithotomy position and primiparae were fixed in stirrups during the second and third stages of labour. There was general lack of support for early mother/baby contact, prevention of hypothermia in the babies and early initiation of breast feeding., Implications for Practice: Based on our findings we suggest that many present maternity ward routines, both physiological and psychological, should be carefully studied. It is also suggested that the midwives reorient their caring practices to more culturally and evidenced-based maternity care. Refresher courses for midwives who have been working for many years are recommended.

During a two year period 901 cases were admitted and diagnosed as benign gynaecological neoplasms. Five hundred and thirty three of these (59.1 pc) were uterine fibroleiomyomata. Of these, 103 had surgery and 13 (12.6 pc) had pedunculated fibroleiomyomata presenting as a vaginal mass. Eight of the 13 cases were treated by vaginal myomectomy. Total abdominal hysterectomy was carried out in two cases because of failed vaginal myomectomy. Two others had total abdominal hysterectomy for dysfunctional uterine bleeding and for satisfied parity. One case absconded. Vaginal myomectomy should be the first choice of treatment for prolapsed submucous leiomyomata. However, in cases with concurrent gynaecological problems or those cases with satisfied parity, total abdominal hysterectomy should be considered. Specific antibiotics should be used pre and post operatively in cases with necrotic tumours.