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Experiences of midwives who are faced with newborns affected by birth asphyxia in rural birth settings, southern Ghana
Research Title: Experiences of midwives who are faced with newborns affected by birth asphyxia in rural birth settings, southern Ghana
Ani-Amponsah, Mary*; Richter, Solina; Conroy, Sherrill - University of Alberta
Background: Neonatal death rates in low and middle income countries showed minimal decline over the past decade in spite of global efforts to reduce the under-5 year mortality rate. Prematurity/low-birth-weight, birth asphyxia, infections and congenital anomalies are the major causes of Under-5 year deaths. Birth asphyxia has received minimal global attention although it is a preventable respiratory emergency. The worst affected are people who live in rural communities where inequitable health coverage is predominant. In Ghana, birth asphyxia rates 2nd to prematurity on the list of causes of neonatal deaths. Very little information exists on midwives' experiences of birth asphyxia although they are the front line health workers.
Aim: To understand the meanings and articulate the experiences of midwives who are faced with newborns affected by birth asphyxia in rural birth settings.
Methodology: Interpretive phenomenology that incorporates Heideggerian philosophy was used to explore midwives' experiences. Thirteen midwives were sampled from rural birth settings in Ghana (Shai-Osudoku District). Data was generated through conversations, field notes, and reflective journaling. Emerging themes produced a rich understanding of midwives’ embodied experiences as they face newborns with birth asphyxia.
Findings: Rural midwifery practice in Ghana is grounded in harmonious communal relationships within restricted health care spaces where silent suffering occur. Midwives experience emotional drowning and adopt spirituality as coping mechanism when faced with asphyxiated newborns. Midwives encounter moral distress and situation-helplessness within hegemonic power structures. Newly qualified midwives shed hidden tears as they practice without mentorship; and unsafe/unethical clinical spaces are created as family members assist in birthing procedures within a culture - defined environment.
Conclusion: New knowledge will serve as a basis for; scaling up practices, policy development; directing capacity building strategies, and implementing research-informed interventions to support midwifery practice, prevent birth asphyxia and improve newborn health outcomes in rural Ghana.
Key words: Birth asphyxia, midwives, experiences, neonatal morbidity, newborn health
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