M.Cur. / Epidural anaesthesia as a method of pain relief during labour has lately become very popular. statistics show that in some labour units up to 70 percent of all patients undergo epidural anaesthesia. The popularity of this method can be attributed to its effectiveness in relieving pain during labour. The anaesthetist commences an epidural block by introducing an epidural catheter into the epidural space. The anaesthetist administers the test dose and the first therapeutic dose. Within a short duration of time (10 to 20 minutes) the patient can already experience the numbing effect of the anaesthetic. This anaesthetic loses its numbing effect within two to three hours and effective pain relief can only be achieved by administering a further dose of local anaesthetic via the epidural catheter. This procedure can be repeated between three to six times during the average duration of labour. Alternatively a continuous epidural infusion procedure can be used. This last method however sometimes requires the administration of additional epidural "top-ups". If the additional "top-ups" are not administered timeously the patient can experience pain and discomfort. These delays in administering the anaesthetic often occur as a result of the anaesthetist being involved in the treatment of other patients - this often occurs in bigger labour wards where epidural anaesthesia is used during labour and caesarian sections by various patients. The active involvement of the midwife in these administrations can prevent the delays that often occur.

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Thesis (Ph. D.)--Ohio State University, 2007. / Title from first page of PDF file. Includes bibliographical references (p. 96-108).

Thesis (DNSc.)--University of Tennessee Health Sciences Center, 2005. / Includes bibliographical references (p. 101-109). Also available on the Internet.

Thesis PlanB (M.S.)--University of Wisconsin--Stout, 2008. / Includes bibliographical references.

M.Cur. / Please refer to full text to view abstract

D.Cur. / The midwife renders a service to assist the individual, family, and\or community to promote, maintain, and restore health during pregnancy, labour and the postpartum period. The nature of the service that the midwife renders is determined by law. The midwife is responsible and accountable for her actions and conduct. It is often expected of the midwife to take responsibility for a patient and to be accountable, although legislation does not support her function. In talking to other midwives and from own experienceit has become clear that the legislation which regulates the practice of the midwife causes confusion and is limiting. As a result of this, midwives sometimes hesitate to act, neglect their duties or act outside their scope of practice. The aims of the study are: • to analyse the legislation which regulates the conduct of the midwife • to propose guidelines for new comprehensive legislation. This study has been conducted in three phases. In phase 1 focus group interviews were used to determine the problems experienced by the midwife. Phase 2 of the study consists of the above mentioned legislation. A survey of available literature is used in the analysis to test the relevance of the legislation. Various problems with the legislation are identified. The legislation causes confusion among midwives, limits her practice and is outdated. In the last phase of the research, guidelines for legislation are formulated in order to resolve the current problems and to prevent the recurrence of problems in future. Recommendations for further research are made.

Thesis (Ph.D.)--University of Alberta, 2009. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Doctor of Philosophy, Faculty of Nursing. Title from pdf file main screen (viewed on October 10, 2009). Includes bibliographical references.

Background: The study described the perspectives and experiences of women and health care providers with regard to use of postnatal care and reasons why some women do not attend postnatal care in order to identify strategies for improving postnatal care services. Methods: An explorative, descriptive, and contextual research design was used. In step one data was collected with semi-structured interviews with seventeen (17) women who attended postnatal care. The second sample consisted of ten (10) women who did not attend postnatal care but brought their babies for well-baby clinic. Focus groups were conducted with midwives who offered postnatal care to women. The midwives of the first focus group worked in the hospital while the second focus group worked at a filter clinic. Results: In step one, some women indicated positive experiences but most women had negative experiences about postnatal care. The positive experiences were related to the satisfaction of the women with good services received and not encountering problems with staff's care. Common concerns mentioned in step one and two about postnatal care were shortage of skilled midwives, need for staff to be trained on postnatal care services, lack of confidentiality, poor infrastructure and non-integration of maternal and child services. Reasons for not attending postnatal care that were mentioned by women in step three were inaccessibility of the health care facilities, poor roads infrastructure, lack of knowledge about postnatal services and socio-cultural factors. Conclusion: Based on the findings, strategies to improve postnatal care were developed: Firstly, the midwives need to be trained on postnatal care and highlighted on current postnatal policies and guidelines. Secondly, woman and baby should attend the postnatal care at the health facility. Thirdly, community health nurses and trained community health workers should visit the women at home soon after birth of the babies. Fourthly, postnatal care should be provided at the family and community level by a trained and skilled midwife during the early postnatal period. Fifthly, combination of care facility and home visit - when the woman and baby are discharged from the hospital, follow- up need to be done at home by the midwife. Lastly, a comprehensive integration of postnatal services with other programmes needs to be enforced and supported by the programme management and policy makers. / MCur, North-West University, Potchefstroom Campus, 2015

Background: The study described the perspectives and experiences of women and health care providers with regard to use of postnatal care and reasons why some women do not attend postnatal care in order to identify strategies for improving postnatal care services. Methods: An explorative, descriptive, and contextual research design was used. In step one data was collected with semi-structured interviews with seventeen (17) women who attended postnatal care. The second sample consisted of ten (10) women who did not attend postnatal care but brought their babies for well-baby clinic. Focus groups were conducted with midwives who offered postnatal care to women. The midwives of the first focus group worked in the hospital while the second focus group worked at a filter clinic. Results: In step one, some women indicated positive experiences but most women had negative experiences about postnatal care. The positive experiences were related to the satisfaction of the women with good services received and not encountering problems with staff's care. Common concerns mentioned in step one and two about postnatal care were shortage of skilled midwives, need for staff to be trained on postnatal care services, lack of confidentiality, poor infrastructure and non-integration of maternal and child services. Reasons for not attending postnatal care that were mentioned by women in step three were inaccessibility of the health care facilities, poor roads infrastructure, lack of knowledge about postnatal services and socio-cultural factors. Conclusion: Based on the findings, strategies to improve postnatal care were developed: Firstly, the midwives need to be trained on postnatal care and highlighted on current postnatal policies and guidelines. Secondly, woman and baby should attend the postnatal care at the health facility. Thirdly, community health nurses and trained community health workers should visit the women at home soon after birth of the babies. Fourthly, postnatal care should be provided at the family and community level by a trained and skilled midwife during the early postnatal period. Fifthly, combination of care facility and home visit - when the woman and baby are discharged from the hospital, follow- up need to be done at home by the midwife. Lastly, a comprehensive integration of postnatal services with other programmes needs to be enforced and supported by the programme management and policy makers. / MCur, North-West University, Potchefstroom Campus, 2015