QUALITY OF INTRA-PARTUM CARE RECEIVED BY PARTURIENT DURING ACTIVE PHASE OF FIRST STAGE OF LABOUR AT UNIVERSITY COLLEGE HOSPITAL, IBADAN, NIGERIA

Abstract

Skilled care at labour and delivery is a strategy for the reduction of maternal mortality ratio In developing countries. The importance of quality intra-parturm care cannot be over-emphasized. Studies on intra-parturm care in Nigeria have focused on the second and third stages of labour. There is paucity of information on the quality of intra-partum care during active phase of first stage of labour. Therefore, this study examined intra-partum care during active phase of first stage of labour at University College Hospital (UCH), Ibadan, Nigeria. A descriptive cross-sectional study was conducted among the parturient who had spontaneous vaginal deliveries (SVDs) in the labour ward of UCH, Ibadan between June and September, 2013. Sample size of 345 was estimated and parturient who had SVDs during the period of study were consecutively recruited. A pre-tested self-administered questionnaire was used to obtain data on socio-demographic characteristics and frequency of psychosocial support received by parturient during active phase of first stage of labour. Labour records of parturient were reviewed for frequency of hourly blood pressure monitoring, hourly pulse rate monitoring, four-hourly vaginal examination, half-hourly fetal heart rate monitoring conducted on the parturient and timely documentation of progress of active phase of first stage of labour on pantogram as recorded on a checklist. The checklist and questionnaire were scored in percentage using 50% point, a score of ≥ 50% was rated as quality/optimal intra-partum care. Data were analysed using descriptive statistics and Chi-Square test, Logistic regression was set at p=0.05. Mean age of the respondents was 30.4±3.8 years. Few (38.3%) respondents were nulliparous patients while 48.4% and 13.3% have had 2 and 3-5 deliveries in the past respectively. Most (84.3%) of the respondents were booked patients and 60.6% had tertiary education. About 41.4% parturient had their blood pressure monitored hourly, 41.2% had their pulse rate monitored hourly, 85.2% had vaginal examination conducted four-hourly and 61.4% had fetal heart rate monitored half-hourly. Progress report of active phase of first stage of labour was not documented on the partograms in 65.2% of parturient. Most (89%) of the respondents received optimal psychosocial support during the active phase of first stage of labour. Quality of intra-partum care was optimal during the active phase of first stage of labour at labour ward of University College Hospital, lbadan Nigeria.