A thesis Submitted to the Faculty of Arts University of the Witwatersrand, Johannesburg, in fulfillment of the requirements for the degree of Master of Arts / The aim of this study was to investigate the effects of social support for African women labouring aione in a Westernized hospital setting. Two high stress groups of first-time mothers, were studied; a mildly hypertensive group and a teenage group. the results indicated support to be moderately effective in both groups. Factors such as the cultural background, the apartheid system, social influences and the environment in which the mothers live may have impacted on the effectiveness of the support. / AC 2018

Fertility is one of the major tenets of demography. Its importance lies in the determination of fertility trends in a country, in a specific time period. These statistical inferences of fertility play an imperative role in population policy formation and planning. Thus the importance of the measurement of fertility remains undisputed. Due to the significance of fertility, its measurement and its profound impact on societies, acknowledging and addressing the quality of fertility data is of great importance. This research study was conceived in response to the above concern. This study aims at addressing and providing insight into birth history data irregularities and determining interventions of working with this issue in the context of South Africa. Through secondary analysis (i.e. descriptive exploratory and comparative analysis) the study sought to firstly establish a demographic profile of women associated with inconsistent and inaccurate reporting of their birth histories. Secondly the research attempted to ascertain a relationship between the socio-economic statuses of individuals and retrospective reporting. A third objective was to note the sex-selectiveness of reporting (i.e. were more girls or boys reported or misreported on in the retrospective birth histories). The study has established that older, married women with some educational attainment, of rural areas from either the middle and lower income categories tend to misreport more frequently than their converse counterparts. Furthermore, a plausible relationship between the socio-economic statuses of individuals was observed. In terms of the sex-selectiveness of reporting, in general, boys were reported on more consistently than girls. However in certain cases, it was found that rural and middle income women reported accurately on girl children born alive and dead girl children. Recommendations made with respect to improve the quality of fertility data for include the proper training of enumerators and data capturers, quality control during data collection, testing of questionnaires, dealing with social, cultural and language barriers and the reinforcement of publicity campaigns for censuses and surveys. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2010.

Although it is considered an everyday occurrence, childbirth is nonetheless an important and dramatic experience in the life of every woman. Childbirth, a normal physiological state in the life of a woman, can be an awe-inspiring and exciting experience, but sometimes disconcerting experiences may also occur. Women sometimes see labour as the end to a long drawn out process following pregnancy and therefore attribute great significance to all occurrences during labour. When complications occur in a usually uncomplicated process of labour, the health care provider must be able to make quick and effective management decisions and implement appropriate interventions. This may include the referral of women in labour to a level of care where complications can be dealt with more effectively, thereby ensuring the best maternal and neonatal outcomes. Patient referral is regarded as a fundamental component of the health care system therefore a well functioning system should ensure that patients are treated in the appropriate manner at the appropriate place at the lowest possible cost to the health system. The goal of this research study was to explore and describe the inter-level health service referral of women in labour by midwives, in order to design guidelines for midwives and other relevant health care providers involved in inter-level health service referral of women in labour in the South African public health care sector. The research design used for this study is a combination of qualitative and quantitative approaches. The paradigmatic perspective of this study was based on the World Health Organization’s Health for All Model. Appropriate data collection and analysis strategies were used for the different stages of the study. Data collection commenced only after permission to conduct the research had been obtained from relevant authorities and University of Port Elizabeth and the Nelson Mandela Metropolitan University structures. Informed consent was obtained from participants included in the study. In stage 1 of this research project, a profile of midwives at lower level maternity care centres was compiled and the perceptions and experiences of midwives working at lower level maternity services, who are responsible for inter-level health referrals of women in labour, were described. Stage 2 described, by means of analysis of maternity case records, aspects of the inter-level referral of women in labour including the profiles of women admitted to midwife obstetric units (MOUs) who are v referred to higher levels of care. Of significance in this study is the appropriateness of midwifery referrals and the maternity care implemented by health care providers during inter-level health service referral of women in labour. In stage 3 clinical guidelines for midwives and other relevant maternity care providers, to assist them in the inter-level health service referral of women in labour, were developed. Findings from stage 1 of this research study revealed that midwives were generally well qualified and sufficiently experienced in the management of women in labour who need referral. Disconcerting findings relating to human and material resource shortages were discovered; these included major problems with patient transportation and difficulties with communication relating to inter-level health service referral of women. These shortages adversely affected midwives’ ability to efficiently care for women during the inter-level health service referral of women in labour in the research area. Stage 2 of the study yielded results of questionable standards of care to women and infants included in the study. A further disturbing finding from the study is the poor state of record keeping. The development of the provisional guidelines in stage 3 of the study was informed by the four main themes identified from the research findings. Before embarking on guideline development, the researcher familiarized herself with theory related to the clinical guidelines. These included clarifying the concept ‘clinical guidelines’, justifying the need for developing clinical guidelines as well as giving consideration to concerns about clinical guidelines. The research findings as well as literature related to these findings informed the researcher on the development of the guidelines. Provisional guidelines were therefore developed on responsibilities of role players in inter-level health service referral of women in labour at first level of referral, namely the midwife obstetric units, transport personnel and maternity care providers at the referral hospital. Steps were taken throughout the study to adhere to ethical standards of research. The researcher will ensure that the research report is available to all health authorities involved, the participants included in the study and the health care providers who may benefit from the research findings.

The study was aimed at exploring and describing factors that influence the delay in reporting for labour by women in Mopani District and to evaluate the impact of the delay in the process and outcome of labour and to develop recommendations to address the contributory factors. The study was conducted at a regional hospital in the Mopani District. A qualitative descriptive research design was used for the participants to describe the factors that delays pregnant woman in reporting for labour in the regional hospital. A non-probability sampling design was used in the study. Data were collected through unstructured one-on-one interview. Thirteen (n=13) pregnant women who delayed reporting for labour in the regional hospital at Mopani District participated in the interviews. Data were collected and analysed through the use of content analysis approach. Seven themes developed from the findings leading to the establishment of the following recommendations including the use of theory as support system, making the availability of resources a priority, increasing capacity of all clinics to offer skilled birth, expansion of Mom-Connect into rural areas, establishment of MWHs in the rural areas, and increasing transportation such as ambulances. / Health Studies / M.A. (Nursing science)

M.Cur. / Women approach the experience of childbirth from their own frame of reference, expectations and the types of experiences which they encountered during their lifetime. Although much is done to prepare women for childbirth and motherhood, little information is obtained about the mother's experience of childbirth during the intra partum period, regardless of delivering naturally or with the administering of epidural anaesthesia. with this research it was endeavoured to gain more knowledge about the experiences of women during childbirth. The midwife can use this knowledge to have better insight in the needs of these women to ensure a better quality of patient care. A qualitative study was undertaken. The phenomenological method (the autobiographical method) was used, within the context of a private hospital on the West Rand. During March to April 1990 unstructured (non formative) interviews were conducted with 10 primigravidas that delivered vaginally. Five of the 10 women made use of epidural anaesthesia. A study of the literature was done to determine what the experts have already ascertained about this phenomenon. Themes were selected from the literature and the women's experiences were accordingly grouped. of this research, it appears that the who have delivered by means of epidural from those who delivered naturally. were identified where women had the same From the findings experiences of women anaesthesia, differ Universal experiences type of delivery. Recommendations were made on how the midwife can contribute to fulfil in the identified needs of the woman in labour.

Thesis (MPH.) -- University of Limpopo, 2022 / The burden of labour and delivery-related complications are health problems that are life-threatening for the fetus and pregnant women. Mokopane hospital in Waterberg of Limpopo Province reports many maternal health complications. There has not been an investigation into the burden of delivery complications and therefore this study aims to investigate the burden of labour and delivery complication experienced by women giving birth at Mokopane hospital of Limpopo province. Purpose: of this study was to explore the burden of labour and delivery-related complications among pregnant women at Mokopane hospital of Limpopo province. Methods: A cross-sectional, retrospective descriptive study was conducted. The study followed a quantitative approach and the researcher completed a questionnaire using clinical records from all delivery files of mothers delivered at maternity between January 2017 to December 2019 Mokopane hospital. Findings: The major finding of this study was the majority of women were at a low risk of pregnancy (69%) followed by a high risk of pregnancy (24%). The study further revealed that (73.7%) of women at Mokopane hospital were delivered through the normal virginal procedure and (25.8%) delivered through Caesarean section. Moreover, about 86% of the mothers were normal after delivery whilst 14% were sick or had complications. Conclusion: This study, therefore, recommends that educational programs about labour and delivery-related complications and related programs should be prioritised for pregnant women. KEY CONCEPTS The burden: Is the intensity or severity of disease and its possible impact on daily life (Gidron 2013). In the context of this study, the burden will refer to the death and loss of health due to labour and delivery-related complications among pregnant women at Mokopane hospital of Limpopo Province. Labour: This is the process of rhythmic uterine contractions which results in cervical dilatation, a descent of the presenting part; and delivery of the fetus, placenta, and membrane. (Anthony & Van Der Spuy, 2002; Clark, Van de Velde, & Fernando, 2016). In the context of this study, labour will be defined as a physiologic process during which the fetus, membranes, umbilical cord, and placenta are expelled from the uterus. Delivery related complication: Is an acute condition arising from a direct cause of maternal death, such as antepartum or postpartum haemorrhage, obstructed labour, postpartum sepsis, a complication of abortion, pre-eclampsia or eclampsia, ectopic pregnancy and ruptured uterus, or indirect causes such as anaemia, malaria and tuberculosis. (WHO, 2018). In the context of this study, delivery related complications will include amongst others severe antenatal bleeding, Postpartum haemorrhage, nonconvulsive hypertensive disorder of pregnancy (pre-eclampsia), Eclampsia: preeclampsia plus convulsions, Convulsions, Prolonged labour, Premature rupture of the membranes, Retained placenta. Pregnant women: Is a woman who is in the period from conception to birth in which the egg is fertilised by a sperm and then implanted in the lining of the uterus then develops into the placenta and embryo, and later into a foetus (Martin, 2015). In the context of this study, a pregnant woman will be described as a woman who is carrying a developing embryo or fetus within her body.

Thesis (M. A. (Nursing)) -- University of Limpopo, 2021 / Indigenous practices are performances that occur naturally in a region or a growing living environment. Most women believe in indigenous practices because of their cultures and social structure. In South Africa regardless of the availability and accessibility of maternal and child health services, 50% of women were found that they still consult traditional birth attendants as their first choice during pregnancy, labour, delivery, and postnatal care. The purpose of the study was to determine the indigenous practices of women during pregnancy, labour and puerperium amongst cultural groupings at selected hospitals in Limpopo Province, South Africa. A Convergent parallel mixed method design was used in the study to collect both qualitative and quantitative data at the same time. Non-probability purposive sampling was used to select 15 participants and Probability simple random sampling was used to select 125 women who were pregnant, in labour and puerperium using slovin’s formula. Data were collected through a semi-structured interview with a guide for qualitative strand and a self-administered structured questionnaire for quantitative srtand. Data were analysed qualitatively using tech’s open coding method and quantitatively using Statistical Package for the Social Sciences (SPSS) Version 25 with the assistance of the University of Limpopo’s Bio-statistician. The results of the study showed that most women use indigeneous practices for protection against witchcraft, fear of giving birth in caesarian section and many other reasons.THPs and church leaders are regarded as the most principled people in their community. Indigenous women are aware of the sign and symptoms during pregnancy, labour, and puerperium which may determine consultation to healthcare practitioners, but they choose THPs and church leaders. Most women still rely on their religious beliefs to assist during their labour. Pregnant women, those in labour and puerperium should be supported to practice their religious beliefs and practices. THPs and church leaders are obliged to teach their clients and ensure that they know the names and components of the traditional medicines and church rituals they use.The nursing education should include indigenous practices in the curriculum so, that healthcare practitioners know about the indigenous practices and can serve as assistance in the training and development of health practitioners who continuously care for women during pregnancy, labour, and puerperium and as a result, may reduce maternal and child morbidity and mortality in Limpopo Province, South Africa.

The thesis “When birthing makes the news: the depiction of women as a newsworthy item in Die Burger (Oos-Kaap)” analyses a common, yet complex news topic in the South African print media due to the sensitive, often sensationalised, nature of the topic. The private experience of birthing is featured more and more in the public domain of newspapers because of widespread service delivery problems within the South African health department. Focussing on the Eastern Cape, I examine the representation of birthing in Die Burger (Oos-Kaap) in texts printed between 2005 and 2007, and scrutinise the media’s monitorial role of a self-appointed public hero acting on behalf of the women, to expose the poor conditions at government hospitals, specifically in the Nelson Mandela Bay region. How the women and their bodies are reported on, creates a discursive tension between the negative portrayals of the birthing women and the monitorial role of the media. The news values of sensationalism and profit are achieved with visceral representations of the reproductive functions of the birthing women. A poststructuralist feminist theoretical framework reveals discourses that perpetuate race, class and gender inequalities in the apparently socially-concerned sample of texts. A Critical discourse analysis (CDA) provides an approach and method to inform a close textual analysis of both the lexical and visual elements of the texts. The discourses in the sample differed from text to text. Despite these differences, the monitorial role of the media is still achieved. My research argues that acting in the public interest with sensationalist copy is still acting in the public interest. I conclude that it is not easy for newspapers to separate sensationalism from accountability. Media practitioners should be aware of their role in constructing women’s identities and be particularly thoughtful when reporting on birthing. In doing so, this research aims to improve the manner in which women and their bodies are reported on within the news industry.

MPH / Department of Public Health / See the attached abstract below

Basic Antenatal Care (BANC) is a way of training or upgrading the knowledge and skills of all nurses, midwives and doctors involved in antenatal care at the primary health care level so that the minimum care can be provided effectively. This study was conducted to investigate the implementation of the BANC program by midwives in the Mdantsane clinics during February 2009. Methods: A descriptive study design was undertaken targeting midwives providing antenatal care to pregnant women, in 14 clinics of Mdantsane. Data was collected from 25 midwives in the clinics, and from 140 ANC cards of women attending ANC on the day of their visit to the clinic. Results: The majority of midwives providing BANC in Mdantsane clinics were not trained in BANC. There were 10 trained midwives and 15 not yet trained. A total of twenty five midwives were involved in the study. The number of visits according to the BANC schedule was well known by the midwives in the study. The content of the visits was well known for the first visit, but for subsequent visits, the participating midwives could not state exactly what they do on these visits. They perceived BANC as something beneficial for both midwives and pregnant women with 24 of the participating midwives rating BANC as advantageous. In completing an ANC card, the midwives scored between 48 percent and 100 percent. Under examination, they scored between 52 percent and 100 percent. Lastly on interpretation and decision making, they scored between 0 percent and 92 percent. This could have troubling consequences for the health status of the mother and baby. Weaknesses in providing antenatal care identified in the study included participating midwives failing to fill in the last normal menstrual period (LNMP) and the estimated date of delivery (EDD), which was a worrying observation. Plotting of the gestational age at first visit was also not carried out well as only 47 percent of the midwives in the study did this, meaning that there would be a miscalculation of the gestational age thereafter throughout the pregnancies. The body mass index (BMI) was not calculated as the maternal height and weight were not written on the ANC card. This should be completed in order to check the nutritional status of the pregnant woman to help supplement, if malnourished, and educate on diet, if overweight. Only 17 percent of the midwives in the study plotted the foetal presentation. Failure to plot foetal presentation could lead to complications during delivery because women with abnormal presentations could end up delivering in a clinic instead of the hospital.Conclusion: This study showed that even though midwives are implementing BANC among pregnant women, it is not being carried out correctly. Therefore the programme will not be as beneficial as it would be if put into practice correctly. This is highlighted by the lack of knowledge from the untrained midwives regarding the content of care on subsequent visits. Thus there is an urgent need for BANC training to be conducted and monitored at various sites.