Experiences of post-partum haemorrhage among post-natal women in Kebbi, Nigeria

The main purpose of the present qualitative case study is to explore experience of post natal women and factors related to post-partum haemorrhage (PPH) care that influences the reporting of labour to the hospital. Postpartum haemorrhage is one cause of maternal mortality that is very difficult to manage due to the problem of implementing evidence-based practice being the low resource countries. Postpartum haemorrhage accounts for 18.6% of maternal deaths in Nigeria. Post-partum haemorrhage is the core issue regarding childbirth-related complications in Nigeria. There have been limited researches on primary postpartum haemorrhage in Nigeria. Therefore, more attention and investigation are still needed to fully investigate the clinical features of primary postpartum haemorrhage. The theories guiding this study are health belief model (HBM) and self-efficacy theory. The application of such theories was possible in the present study because it demonstrate actions through skill development activities and provides the support that enhances self-efficacy and the likelihood of successful behavioural changes among post natal women. The qualitative research methodology, case study approach was applied because the present study focuses on a group of individual women admitted in the hospital for post-partum haemorrhage (PPH) care in Sir Yahaya memorial hospital, Kebbi state, northern Nigeria. The major source of data collection adopted in the present study to meet the purpose of the study was face to face interviews. Additionally, non-participation observation at the maternity unit meetings and examination of official and private documents were the other sources of data s. The trustworthiness of the present study was ensured through triangulation, member check, peer examination, researcher’s position or reflexivity, and the documentation of audit trail. Five themes evolve from the women’s response on the experience of post-partum haemorrhage (PPH) care on admission. (1) Women expectation (2) services of clinical and non-clinical staff (3) poor respectful maternity care (4) confusion of correlation (5) Communication barrier. Four themes emerged the women’s response on the factors that influence reporting for labour and PPH care: (1) limited access to facility, 2) basic resources, 3) ethics and confidentiality and 4) unstable industrial harmony. In conclusion, increase in knowledge of post natal women and improvements staff attitudes towards women at the facility leads to enhanced reporting for labour and post-partum haemorrhage (PPH) care as well as corresponding reduction in morbidity and mortality associated with post-partum haemorrhage PPH. Implication of the study is that knowledge, skills, and attitudes of the health care providers working at the study site and indeed labour/delivery and postpartum units of all health facilities can be improved significantly following the implementation of the educational program and continues development program. The recommendation is that continuing education should be made compulsory for all midwifery and obstetric nurses.

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