Continuous Labour Support in Public Health Facilities in Nigeria: Midwives' Perception and Attitude

Saturday, 28 October 2017: 2:35 PM

Olabisi Ibitoye, PhD
School of Nursing, University of the Western Cape, Cape Town, South Africa
Deliwe Rene Phetlhu, PhD, MHS, BA
School of Nursing, University of Western Cape, Cape Town, South Africa


 Pregnancy and childbirth are regarded as normal physiological events, but, it is usually associated with great emotional, psychological and cultural significance for women and their families (Otley, 2013). The childbirth experience is influenced by several factors that could have an impact and result to either an unsatisfactory or a satisfactory childbirth experience. These factors include a sense of security, perceived control, experiences of prior deliveries, involvement in decision-making, the nature of organisational care and quality of support during labour (Dencker, Taft, Bergqvist & Lilja 2010; Hodnett, Gates, Hofmeyr &Salaka, 2012).

Traditionally in all cultures across the globe, women usually gave birth surrounded by family members and with the support of other women, but with the movement of birth to the hospital, this valued tradition was lost and women became subject to and dependent on medical technology and hospital routines (Hodnett, Gates, Hofmeyr &Salaka, 2013). Several studies have documented the re-emergence and contribution of Continuous Labour Support (CLS) to women satisfactory childbirth experience mostly in developed countries , but CLS implementation and practice has remained the exception rather than the rule in most developing countries, particularly Nigeria (Sapkota, Kobayashi, Kakehashi, Baral, & Yoshida, 2012; Hodnett et al, 2013).


The study explored the Nurse/Midwives perceptions and attitudes to Continuous Labour Support (CLS) public health facilities in the South-West region of Nigeria and also explored Nurse/Midwives opinion to CLS by a preferred person or persons from labouring women’s social networks using the Airhihenbuwa (1989; 2014) PEN-3 cultural model.


A qualitative, exploratory and descriptive design was adopted for the study. The study population were Nurse/Midwives (n= 45) selected purposefully in seven public health facilities in Ondo state, Nigeria. Focus group discussions were conducted until data saturation occurred. Data was analysed through Tesch’s method of thematic analysis yielding themes and categories.



The study findings reveal only occasional/discretional practice of CLS in the public health facilities, lack of policy and guideline for its implementation was also reported. The Nurse/Midwives expressed a positive disposition to CLS introduction and use women preferred person or persons from their social networks based on beneficial effect to all stakeholders. However, CLS implementation in public health facilities in Nigeria will depend largely on complete overhauling existing infrastructure with adequate measures to other challenges identified in the study.

Linking Evidence to Action

There is need to ensure culturally congruent maternity care in all sector in Nigeria. The study’s findings highlighted the need, benefit/ challenges as well as the enablers to CLS practice in public health facilities in Nigeria. CLS introduction and implementation in resource limited and high mortality country like Nigeria may promote the therapeutic presence and family involvement in women care during childbirth. It may also increase utilisation and skilled birth attendance in public health facilities, hence contribute not only to culturally inclined satisfactory childbirth experience but to the reduction of preventable mortality associated with pregnancy and childbirth.