Perspectives of South African midwives on their learning needs pertaining to intrapartum cardiotocograph interpretation

Abstract

AIM : To explore and describe the perspectives of South African midwives on their learning needs for intrapartum cardiotocograph (CTG) interpretation. BACKGROUND : Intrapartum CTG monitoring and interpretation is standard care for women who are considered at high risk. Its purpose is to detect foetal heart rate abnormalities and monitor uterine contractions. Midwives must be knowledgeable and competent in the skill of CTG interpretation, as this is a means of monitoring foetal wellbeing during labour. Midwives are expected to be trained in this skill by the time they graduate and become independent practitioners. SETTING(S) : This study was conducted in four hospitals in Gauteng Province, South Africa: two district and two central hospitals. METHODS : A qualitative, descriptive and contextual approach was used in this study. Data was collected from 30 nurse midwives working in the labour ward through focus group discussions and one-on-one semi-structured interviews carried out between August and October 2023. Thematic analysis was used to analyse the data. ATLAS.ti was used to manage the data during analysis. FINDINGS : Three themes were identified: inadequate CTG training, factors affecting midwives’ confidence during CTG interpretation, and avenues for empowerment. CONCLUSION : The findings of the study demonstrate that more efforts need to be made to upskill the level of training of midwives in the skill of CTG interpretation at undergraduate level as well as post-qualification. This will make midwives knowledgeable and competent practitioners in the skill of CTG interpretation. Furthermore, it will improve their clinical reasoning skills, thereby improving maternal and neonatal outcomes.