ABSTRACT
This study investigated the factors associated with Prolonged Labour among Women aged 32-45 years in Etche Local Government Area. The descriptive survey design was used in conducting this study. Four research questionsand four hypotheses were used to carry out the study. The sample size for this study was 400 women selected using Taro Yamene for large population. A two stage (multistage) were used to select the sample for this study. The instrument for data collection was a structured questionnaire titled Factors Associated with Prolonged Labour Questionnaire (FAPLQ) .The questionnaire consisted of two parts, the first part seek for information on demographic data of the respondents while the second part contained the items statement responded to using yes or no options. The face and content validity was done. The instrument for data collection was pre-tested for reliability, familiarity related to questionnaire. The questionnaire and tools for measurement were pre-tested among 5%(20) of the sample size 400 in Etche Local government area of Rivers State. Mean and standard deviation were used to analyze the research questions The results of the study shows that there was a significant relationship between level of education and Prolonged Labour among women aged 32 – 45 years (F=5.558, df=3, p<.05),There is no significant relationship between socio-economic status and Prolonged Labour among women aged 32 – 45 years (F=0.698, df=2, p>.05) and there is no significant relationship between occupation and prolonged labour among women aged 32 – 45 years (F2, 397=0.420, p>.05) and there is no significant relationship between proximity to health care facility and prevalence of prolonged labour among women aged 32 – 45 years in Etche Local Government Area of Rivers State F1, 398=0.278, p>.05). And thus it was recommended among all that: The government should build a well-equipped comprehensive health centers in all the communities in Etche Local Government Area of Rivers State.The government should post resident doctors and trained health personnel to each of the health centers in Etche Local Government Area of Rivers State. There should be regular antenatal check-up and treatment among pregnant women. Mid-wives should enlighten pregnant mothers on the benefits of relaxation, exercise and routine drugs taking as they may help to prevent prolonged labour.
CHAPTER ONE
Introduction
1.1 Background of study
Prolonged Labour is a problem that many women face when giving birth. It can cause a number of problems but with the right care from doctors and nurses, there do not have to be any lasting complication unfortunately for some children, this difficult labour will result in complication that cause brain damage and ultimately cerebral palsy. Astrid & Hildingsson (2014) Prolonged Labour very often causes suffering from difficulties that may have lifelong implication, this study aimed to explore the prevalence and treatment of Prolonged Labour and to compare birth outcome and women’s experience of prolonged and normal Labour. World health organization WHO (2011), Prolonged is an important causes of maternal and perinatal mortality and morbidity. Thus failure of Labour to progress has become one of the leading indications from primary caesarean section, particularly in first time mothers. There is growing concern that caesarean section is performed too soon in many cases without exploring less invasive intervention that could lead to vaginal birth. Prolonged labour is the inability of a woman to proceed with childbirth upon going into Labour. Prolonged Labour typically last over 20 hour for the first time mothers and over 14 hour for women that have already had children. According to Lowe (2007), Prolonged Labour is a common birth complication and constitutes the major indication of instrument deliveries and delivery by emergency caesarean section. Prolonged labour is associated with an increased risk of complicated deliveries and intervention such as operative delivery, postpartum hemorrhage, anal sphincter injury, chorioamnion it is and transfer to a neonatal intensive care unit. It refers to Labour that goes on for about 18 to 24 hours after regular contraction begin. For twins a Labour that goes on for 16 hour is considered prolonged. Mothers having their first baby are expected to be in Labour for a longer period of time so prolonged labour may not be declared until 22 to 24 hours whereas for second or third time mothers labour may be considered prolonged after 16 to 18 hours. Prolonged labour put at risk for developing cerebral palsy. Exactly why this is true is not completely understood or may not be known in every cases but there are several likely possibilities. If labour is prolonged but the baby is already in the birth canal the doctor may use instruments to pull the baby out the use of forceps or a vacuum extractor can cause damage to a baby skill. Literally by crushing it with too much force this can easily lead to brain damage that causes cerebral palsy.
Age is one the variables that determine the factors that are associated with Prolonged Labour among women. Women that are less than 20 years old can adversely affect the health of the mother as well as the growth and development of the fetus because the reproductive organs are still immature for pregnancy. Adolescent pregnancy complication (<20 years) is higher than during healthy reproductive period (20-35 years). This situation will be difficult when coupled with psychological, social, and economic stress. Mothers with health over 35 years of age, the function of their reproductive organs have begun to decline and many other diseases can make the mother's condition week, thereby disrupting the mother's blood circulation to the fetus.
Parity is one of the variables that show the number of children a woman has ever born. Parity is an important factor in determining the fate of the mother and fetus both during pregnancy and childbirth. High parity will be more at risk of experiencing sagging in the uterine wall so that it will be more susceptible to having a long Labour. A parity number of 1 or more than 3 has been shown to increase the incidence of Prolonged Labour compared to mothers with parity of 2-3. Mothers with parity 1 or> 3 tended to experience complete opening longer than mothers with parity 2-3.5The logistic regression test results showed a significance value (p = 0.015), it means that there was an influence between maternal parity and the incidence of Prolonged Labour. The parity coefficient (-0.660) showed the direction of the negative influence between maternal parity and the incidence of Prolonged Labour. The value of Exp (B) showed that mothers with parity at risk had a 1.9 times chance of experiencing Prolongeded Labour. This is in line with research where in his research, there was a significant relationship (p = 0.042) between parity and Prolonged Labour.
1.2 Statement of Problem
Prolonged labour accounts for high rate of morbidity and mortality among women age 32 to 45 years of age. It is apparent that some people are either aware or ignorant of the damaging effect on their health due to prolonged labour. Prolonged labour presents a picture of mental anguish and physical morbidity which often leads to surgical intervention and may produce a permanent revulsion to childbirth, expressed by the mother as voluntary infertility; it constitutes a danger to the survival and subsequent neurological development of the infant. The harrowing experience is shared by relatives, and by doctors and nurses to the extent that few complications tarnish the image of obstetrics. Prolonged Labour has an impact on both the mother and the fetus. The impact on the mother is to increase the incidence of life-threatening postpartum hemorrhage, whereas in the fetus it can increase the incidence of asphyxia or lack of oxygen, consequently increasing the risk of death. Therefore, this research study is aimed at investing the factors associated with Prolonged Labour among women age 32-45 years in Etche Local Government Area of Rivers State.
1.3 Objectives of the Study
General Objective
The main aim of this study is to assess magnitude of Childbirth fear and associated factors among pregnant women at Public Hospitals in West Wollega, Oromiya Region, Nigeria, 2024.
Specific Objectives
Ø To assess the magnitude of Childbirth fear among pregnant women at Public Hospitalsin West Wollega, Oromiya Region, Nigeria, From April 20 to May 20,2024.
Ø To identify factors associated with Childbirth fear among pregnant womenat Public Hospitals in West Wollega, Oromiya Region, Nigeria, From April 20 to May 20, 2024.
1.4 Research Questions
The following research questions was used in the study.
1. How does level of education affect the Prolonged Labour among Women aged 32-45 years in Etche Local Government Area?
2. How does socio-economic status lead to the Prolonged Labour among Women Aged32-45 years in Etche Local Government Area?
3. How does occupation leads to Prolonged Labour among Women aged 32-45 years in Etche Local Government Area?
4. What are the effect of the hospital based prevalence of obstructed Labour among Women aged 32-45 years in Etche Local Government Area?
1.5 Hypotheses
The following hypotheses guided the study.
1. There is no significant difference between occupation and Prolonged Labour among Women age 32-45 years in Etche Local Government Area.
2. There is no significant difference between the level of education and Prolonged Labour among women age 32-45 years in Etche Local Government Area.
3. There is no significant difference between socio- economic status and Prolonged Labour among women age 32-45 in Etche Local Government Area.
4. There is no significant difference between hospital based prevalence of obstructed Labour among women age 32-45 years in Etche Local Government Area.
1.6 Significance of the study
Researches on labourwere conducted in developed countries but there are limited researches on prolonged labour among women in developing countries like Nigeria. Childbirth care is very essential and lifesaving maternal and child health-care intervention. Understanding the magnitude of childbirth fear and associated factors is an important factor in altering health of women. Therefore, the findings from this study will reveal insights from women who come to hospital for childbirth care. The findings from the study may have implications for midwives/health care providers, women and policy makers by improving awareness and evidence based practice. It may also have strong implications for governmental and nongovernmental organizations who are interested in working with maternal health to plan future intervention.
The findings from the study might also provide baseline data for future researchers interested to conduct further investigation on Childbirth fear.
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