Quality of maternity care for adolescent mothers in Mbabane, Swaziland


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Abstract

Early pregnancy and unplanned childbirth may have far-reaching physical, psychological and social consequences for the adolescent girl and her offspring and are therefore public health issues of concern. A number of evidence-based maternity practices might, if properly applied, prevent unnecessary health-related problems in mothers and newborns, postnatally. In order to identify the areas of maternity practice that require improvement in Swaziland, the overall aim of this study was to generate systematic data on the maternity care and social support provided by health professionals (for adolescent mothers and their children) on admission, in the labour ward, and during and after delivery. The study was carried out during a 3-month period from April to June 1998. All pregnant adolescents with an uneventful term pregnancy, admitted to the Mbabane Government Hospital maternity ward in the morning of the study days, were informed about the purpose of the study and asked if they would like to participate. A total of 33 pregnant adolescents agreed and in-depth interviews were conducted with those participants. Observations and checklists were used to assess the maternity care given to the study participants. Results revealed that on admission to the labour ward, verbal communication and interaction between the midwife and the adolescent were minimal, and none of the adolescents was encouraged to bring a social support person to remain with them during labour. During the progress of labour, nearly 50% of the adolescent mothers developed complications and ≈27% had a lower-segment Caesarean section. Special attention should therefore be paid to adolescent sexual and reproductive health service needs. These should include contraceptive counselling in order to prevent pregnancy at a young age and also to improve their sexual and reproductive health statuses.

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