Challenges midwives experience caring for mechanically ventilated women in a labour ward of a public tertiary hospital

Abstract

Introduction: In South Africa, especially in Gauteng Province, the healthcare system has been increasingly overcrowded by high-risk obstetrician women. These women are being cared for in the labour ward by a limited number of healthcare professionals. There are very few intensive care beds available, leading to women not being transferred to intensive care units after being mechanically ventilated in the labour ward. A standard labour ward must be able to provide short-term mechanical ventilation while awaiting the transfer of the women to a critical care unit. There seems to be a lack of skills among the midwives who take care of these critically ill women who are mechanically ventilated in the labour ward. Aim: The study explored the challenges midwives experience taking care of mechanically ventilated women in a standard labour ward in Gauteng Province, South Africa. Methodology: A qualitative research design was used to explore the challenges midwives experience caring for mechanically ventilated women in a standard labour ward at a public hospital in Gauteng province, South Africa. The method of non-probability purposive and convenience sampling aided in obtaining in-depth discussion from the midwives, who were chosen on the basis of their knowledge and experience with the research subject. Results: The research provided insight into the challenges midwives experience caring for high-risk women who need intensive care. The themes focused on midwives’ challenges in caring for mechanically ventilated women. Challenges included midwives' competency challenges, midwives' medical-legal challenges, inter- and intra-professional challenges, and healthcare system-related challenges. Recommendations: For midwives to render proper nursing care, all midwives who work with mechanically ventilated pregnant women should be trained. Early referrals should be made to higher levels of care, like the intensive care unit, where multidisciplinary levels of staff and treatment are available. Training recommended includes training the midwives about the mechanical ventilator machine settings and caring for pregnant women who are mechanically ventilated. Keywords: midwives, nursing, mechanically ventilated women, labour ward, and tertiary hospital