Health workers’ perspectives on mediators of elongated parturition among females of reproductive age: A descriptive study

Year 2025, Volume: 17 Issue: 1, 21 - 30, 30.04.2025

Godson Ajuzie Adaobi Okerulu Osah Onwuka

https://doi.org/10.56484/iamr.1654548

Abstract

Objective: Prolonged labor, also known as elongated parturition, poses significant health risks to mothers and newborns, contributing to maternal and fetal morbidity and mortality. This study explores health workers' perspectives on the mediators of elongated parturition among females of reproductive age to identify and address contributing factors.
Methods: This descriptive study was conducted among 100 health workers from two health centers in Rivers State, Nigeria. Data were collected using open-ended questionnaires and audio recordings and analyzed using percentage distribution.
Results: Among the 100 participants, 30% were male, 70% female; 5% were trained health workers, and 13% were students. Most (82%) had tertiary education, 87% were Christians, and 13% practiced other religions. Factors influencing prolonged labor included inadequate antenatal care (40%), incompetent pelvis (20%), and maternal inability to push (40%). All participants (100%) had witnessed cases, with occurrences reported annually (53%) or depending on the woman (41%). Psychological and physiological effects included maternal distress (33%), maternal death (32%), child death (12%), and other health issues (23%). Suggested interventions included improved antenatal care (55%), health education (30%), and community mobilization (15%), with 68% of participants supporting these measures, 5% opposing, and 27% supporting them conditionally. Constraints included women’s choice (25%), religion (25%), unskilled health workers (40%), and reliance on traditional birth attendants (10%).
Conclusion: Health workers' perspectives indicate that elongated parturition significantly impacts maternal and fetal outcomes. Addressing mediators such as inadequate antenatal care and unskilled health workers, while increasing community awareness and health education, is crucial for reducing associated risks and improving maternal and neonatal health.

Keywords

Elongated parturition , mediators , maternal health , reproductive age , health workers

References

• Ajuzie G C, Onwuka O M, Okerulu A L. Pregnancy termination, consequences, and influencing factors: A study on perceptions of women of childbearing age. Yemen J Med. 2024; 3(1):43-7.
• Thornton J M, Ramphul M. Mechanisms and management of normal labour. Obstet Gynecol Reprod Med. 2023; 33(6):160-7.
• Cohen W R, Friedman E A. The second stage of labor. Am J Obstet Gynecol. 2024; 230(3):S865-75.
• Delgado-Pérez E, Rodríguez-Costa I, Vergara-Pérez F, Blanco-Morales M, Torres-Lacomba M. Recovering sexuality after childbirth. What strategies do women adopt? A qualitative study. Int J Environ Res Public Health. 2022; 19(2):950.
• Lozic M, Ludwig M. Oxytocin. Encycl Mol Pharmacol. 2022; 1203-9. Cham: Springer International Publishing.
• Badejoko O, Onwudiegwu U. Management of Normal and Abnormal Labour. Cont Obstet Gynecol Dev Countries. 2021; 117-27.
• Cohen W R, Friedman E A. Clinical evaluation of labor: an evidence-and experience-based approach. J Perinat Med. 2021; 49(3):241-53.
• Young R C, Marinescu P S, Seligman N S. Monitoring uterine contractions during labor: current challenges and future directions. Am J Obstet Gynecol. 2023; 228(5):S1192-208.
• Pavličev M, Romero R, Mitteroecker P. Evolution of the human pelvis and obstructed labor: new explanations of an old obstetrical dilemma. Am J Obstet Gynecol. 2020; 222(1):3-16.
• Wilson R D. The real maternal risks in a pregnancy: a structured review to enhance maternal understanding and education. J Obstet Gynaecol Can. 2020; 42(11):1364-78.
• Pouca M C, Ferreira J P, Parente M P, Jorge R M, Ashton-Miller J A. On the management of maternal pushing during the second stage of labor: a biomechanical study considering passive tissue fatigue damage accumulation. Am J Obstet Gynecol. 2022; 227(2):267-e1.
• Doğan E K, Çevik S. Determining the Impact of Cervical Dilation at Admission on Intrapartum Interventions and Labor Satisfaction in Pregnant Women. J Educ Res Nurs. 2024; 21(2).
• Uvnäs-Moberg K. The physiology and pharmacology of oxytocin in labor and in the peripartum period. Am J Obstet Gynecol. 2024; 230(3):S740-58.
• Cohen W R, Friedman E A. The second stage of labor. Am J Obstet Gynecol. 2024; 230(3):S865-75.
• Jaiyesimi R A, Ojo O E, Awe A F. Caesarean delivery and peripartum hysterectomy. Cont Obstet Gynecol Dev Countries. 2021; 203-21.
• Langley-Evans S C, Pearce J, Ellis S. Overweight, obesity and excessive weight gain in pregnancy as risk factors for adverse pregnancy outcomes: A narrative review. J Hum Nutr Diet. 2022; 35(2):250-64.
• Jallu S Y, Manja E K, Ba-an M T. Work Place Factors Contributing To Stress Among University Teachers And Coping Strategies: A Study Of Tamale Technical University. Ind J Econ Bus Manag. 2023; 3(1):8-21.
• Callahan E C, Lee W, Aleshi P, George R B. Modern labor epidural analgesia: implications for labor outcomes and maternal-fetal health. Am J Obstet Gynecol. 2023; 228(5):S1260-9.
• Ermatov N J, Bobomuratov T A, Sagdullaeva M A. Prolonged newborns and prolong pregnancy: A modern view on the problem. Int J Health Med Sci. 2022; 5(1):26-30.
• Chang K J, Seow K M, Chen K H. Preeclampsia: Recent advances in predicting, preventing, and managing the maternal and fetal life-threatening condition. Int J Environ Res Public Health. 2023; 20(4):2994.
• Vasquez V, Desai S. Labor and delivery and their complications. Rosen’s emergency medicine: concepts and clinical practice. 2018; 2296-312.
• Solomon N, Tesfaye M. Traditional practices during pregnancy and childbirth among mothers in Shey Bench District, South West Ethiopia. SAGE Open Med. 2022; 20503121221098139.
• Head S K, Yount K M, Sibley L M. Delays in recognition of and care-seeking response to prolonged labor in Bangladesh. Soc Sci Med. 2011; 72(7):1157-68.
• Hosseini Tabaghdehi M, Kolahdozan S, Keramat A, Shahhossein Z, Moosazadeh M, Motaghi Z. Prevalence and factors affecting the negative childbirth experiences: a systematic review. J Matern Fetal Neonatal Med. 2020; 33(22):3849-56.
• Pop-Jordanova N. Childbirth-related psychological trauma. Prilozi. 2022; 43(1):17-27.
• Ramazani I B, Ntela S D, Ahouah M, Ishoso D K, Monique R T. Maternal mortality study in the Eastern Democratic Republic of the Congo. BMC Pregnancy Childbirth. 2022; 22(1):452.
• Wafula S T, Nalugya A, Kananura R M, Mugambe R K, Kyangwa M, Isunju J B et al. Effect of community-level intervention on antenatal care attendance: a quasi-experimental study among postpartum women in Eastern Uganda. Glob Health Action. 2022; 15(1):2141312.
• Sundari T K. The untold story: how the health care systems in developing countries contribute to maternal mortality. Women Health Polit Policy. 2020; 173-90.
• Withers M, Kharazmi N, Lim E. Traditional beliefs and practices in pregnancy, childbirth and postpartum: A review of the evidence from Asian countries. Midwifery. 2018; 56:158-70.
• Dewi I S, Anggraini H, Silaban T D. Relationship between Mal Presentation, Contractions and Baby Weight with Prolonged Parturition in the Teluk Lubuk Health Center Working Area in 2020. Sci Midwifery. 2022; 10(2):574-9.