Comparison of contraceptive discontinuation in users of a copper intrauterine device against depot medroxyprogesterone acetate injectable
- Authors: Dekile-Yonto, Nolusindiso
- Date: 2018
- Subjects: Contraceptives Birth control Women's health services
- Language: English
- Type: Thesis , Masters , Magister of Curationis
- Identifier: http://hdl.handle.net/10353/15520 , vital:40422
- Description: The dynamics of continued contraceptive use, switches to alternatives, or the outright failure of contraception is strong indicators of the effectiveness of health care programmes for women or couples (Ali, Cleland & Shah, 2012:6). Furthermore, unplanned pregnancies often lead to undesirable health, economic, social, and psychological consequences for women (Sedgh, Singh & Hussain., 2014). There is a need to better understand the reasons for discontinuation of contraception to enable health care workers to address the gaps in the provision of family planning services. For this reason, the researcher embarked on a follow-up study of a randomised, controlled trial, which compared the effects on depression and sexual functioning of women after childbirth of a Copper Intrauterine Contraceptive Device (Cu-IUD) with Depot Medroxyprogesterone Acetate (DMPA), (Singata-Madliki, 2014:5). The objectives of the follow-up study was to do a once-off follow-up of the original participants, three years after randomisation.
- Full Text:
- Date Issued: 2018
- Authors: Dekile-Yonto, Nolusindiso
- Date: 2018
- Subjects: Contraceptives Birth control Women's health services
- Language: English
- Type: Thesis , Masters , Magister of Curationis
- Identifier: http://hdl.handle.net/10353/15520 , vital:40422
- Description: The dynamics of continued contraceptive use, switches to alternatives, or the outright failure of contraception is strong indicators of the effectiveness of health care programmes for women or couples (Ali, Cleland & Shah, 2012:6). Furthermore, unplanned pregnancies often lead to undesirable health, economic, social, and psychological consequences for women (Sedgh, Singh & Hussain., 2014). There is a need to better understand the reasons for discontinuation of contraception to enable health care workers to address the gaps in the provision of family planning services. For this reason, the researcher embarked on a follow-up study of a randomised, controlled trial, which compared the effects on depression and sexual functioning of women after childbirth of a Copper Intrauterine Contraceptive Device (Cu-IUD) with Depot Medroxyprogesterone Acetate (DMPA), (Singata-Madliki, 2014:5). The objectives of the follow-up study was to do a once-off follow-up of the original participants, three years after randomisation.
- Full Text:
- Date Issued: 2018
Exploring women's experience of fundal pressure during the second stage of labour
- Authors: Okafor, Uchenna Benedine
- Date: 2018
- Subjects: Labor (Obstetrics) Childbirth
- Language: English
- Type: Thesis , Masters , Magister of Curationis
- Identifier: http://hdl.handle.net/10353/15532 , vital:40424
- Description: Background and Aim: Despite the use of fundal pressure globally, there is a scarcity of information available on how women experience the application of uterine fundal pressure (UFP) during the second stage of labour. The aim of study was to explore the experiences of women concerning UFP application during the second stage of labour. Understanding women’s perception about UFP is important in informing the generation of new ideas to improve on the application of UFP for better outcomes. Methods: This was a qualitative, interpretive, and phenomenological analysis designed to explore the experiences of women regarding the application of UFP during the second stage of labour. Hermeneutics was applied to interpret the participants’ descriptions of their experiences as they tried to make sense of their exposure to UFP; bearing this in mind, the participants’ own interpretation was not distorted. The researcher immersed herself in each transcript, in order to make sense of each participant’s experiences and to gain a sense of what the participant had experienced during UFP application. Each interview was transcribed and analysed independently; and the convergences and divergences of themes were identified without losing the original meaning of each participant’s description before moving on to the subsequent interviews. The target population was women who had had UFP during second stage of labour. A purposive sampling method was used to select three women who were admitted to the DVDHMOU during the research period and who met the inclusion criteria. Information was collected through individual face-to-face interviews and semi-structured interview guide. The principal question was framed as: “Can you please share with me how you felt when the midwives pushed on your tummy to get the baby out”? An audio tape was used to record the interviews, and a notepad was used to make notes of gestures such smiles or other facial expressions. After each interview, the recorded interview was transferred onto a laptop and a file was opened for the interviewee, identified by a pseudonym. The interviews were transcribed verbatim as Word documents. Trustworthiness was maintained by applying the principles of credibility, transferability, dependability and conformability. Ethical approval was granted by the Ethical Committee of the University of Fort Hare. Permission to conduct the study was sought from the Eastern Cape Research Committee and Buffalo City Metropolitan Health District. Informed consent was obtained from the participants prior to data collection. Each interview was analysed separately after completion. Data was analysed using thematic content analysis applicable to interpretative phenomenological analysis (IPA) studies using six steps: reading and re-reading; initial noting; developing emergent themes; searching for connections across the emergent themes; moving to the next case; and lastly, looking for patterns across cases. Findings: The findings of this study indicated that the informants had feelings of fear, loneliness, worry and tearfulness; but also happiness associated with UFP during second stage of labour. They were also worried and expressed fear and anxiety concerning their infants; and their ability to give birth increased as they get tired in the process of pushing during UFP application. However, seeing their infants for the first time took most of the worries away, and all informants expressed relief when the birthing process was over. They also felt that their birthing experience was a very painful event; and were left alone, and they had not been given anything to drink or eat during labour. Midwives threatened them that their inability to pushing appropriately, could cause the death of their infants, leaving them with feelings of guilt and despair when their babies did not cry directly after birth. The findings demonstrated that midwives did not properly inform women what to expect during the second stage of their labour, whilst the midwives expected birthing mothers to know what was happening to them and how to react. Women in labour therefore depended almost entirely on information received from family members, and went into labour with preconceived ideas about labour pain. Although women do experience pain during the second stage of labour, the application UFP increased their pain. Four main themes emerged from the analysis, which are: perceived severity of UFP pain,emotional/physical reaction to UFP pain, perceptions of UFP and perception of midwives care and treatment. Conclusion: The uterine fundal pressure is not a pleasant experience for the women in the second stage of labour. Labouring women experienced pain, fear, and anxiety. However, they felt a sense of happiness after delivery. Before the application of UFP during the second stage of labour, midwives should explain to women the process of UFP application and what they can expect to happen; and where possible, and after explaining the procedure, midwives should get written permission before they apply the intervention during labour.
- Full Text:
- Date Issued: 2018
- Authors: Okafor, Uchenna Benedine
- Date: 2018
- Subjects: Labor (Obstetrics) Childbirth
- Language: English
- Type: Thesis , Masters , Magister of Curationis
- Identifier: http://hdl.handle.net/10353/15532 , vital:40424
- Description: Background and Aim: Despite the use of fundal pressure globally, there is a scarcity of information available on how women experience the application of uterine fundal pressure (UFP) during the second stage of labour. The aim of study was to explore the experiences of women concerning UFP application during the second stage of labour. Understanding women’s perception about UFP is important in informing the generation of new ideas to improve on the application of UFP for better outcomes. Methods: This was a qualitative, interpretive, and phenomenological analysis designed to explore the experiences of women regarding the application of UFP during the second stage of labour. Hermeneutics was applied to interpret the participants’ descriptions of their experiences as they tried to make sense of their exposure to UFP; bearing this in mind, the participants’ own interpretation was not distorted. The researcher immersed herself in each transcript, in order to make sense of each participant’s experiences and to gain a sense of what the participant had experienced during UFP application. Each interview was transcribed and analysed independently; and the convergences and divergences of themes were identified without losing the original meaning of each participant’s description before moving on to the subsequent interviews. The target population was women who had had UFP during second stage of labour. A purposive sampling method was used to select three women who were admitted to the DVDHMOU during the research period and who met the inclusion criteria. Information was collected through individual face-to-face interviews and semi-structured interview guide. The principal question was framed as: “Can you please share with me how you felt when the midwives pushed on your tummy to get the baby out”? An audio tape was used to record the interviews, and a notepad was used to make notes of gestures such smiles or other facial expressions. After each interview, the recorded interview was transferred onto a laptop and a file was opened for the interviewee, identified by a pseudonym. The interviews were transcribed verbatim as Word documents. Trustworthiness was maintained by applying the principles of credibility, transferability, dependability and conformability. Ethical approval was granted by the Ethical Committee of the University of Fort Hare. Permission to conduct the study was sought from the Eastern Cape Research Committee and Buffalo City Metropolitan Health District. Informed consent was obtained from the participants prior to data collection. Each interview was analysed separately after completion. Data was analysed using thematic content analysis applicable to interpretative phenomenological analysis (IPA) studies using six steps: reading and re-reading; initial noting; developing emergent themes; searching for connections across the emergent themes; moving to the next case; and lastly, looking for patterns across cases. Findings: The findings of this study indicated that the informants had feelings of fear, loneliness, worry and tearfulness; but also happiness associated with UFP during second stage of labour. They were also worried and expressed fear and anxiety concerning their infants; and their ability to give birth increased as they get tired in the process of pushing during UFP application. However, seeing their infants for the first time took most of the worries away, and all informants expressed relief when the birthing process was over. They also felt that their birthing experience was a very painful event; and were left alone, and they had not been given anything to drink or eat during labour. Midwives threatened them that their inability to pushing appropriately, could cause the death of their infants, leaving them with feelings of guilt and despair when their babies did not cry directly after birth. The findings demonstrated that midwives did not properly inform women what to expect during the second stage of their labour, whilst the midwives expected birthing mothers to know what was happening to them and how to react. Women in labour therefore depended almost entirely on information received from family members, and went into labour with preconceived ideas about labour pain. Although women do experience pain during the second stage of labour, the application UFP increased their pain. Four main themes emerged from the analysis, which are: perceived severity of UFP pain,emotional/physical reaction to UFP pain, perceptions of UFP and perception of midwives care and treatment. Conclusion: The uterine fundal pressure is not a pleasant experience for the women in the second stage of labour. Labouring women experienced pain, fear, and anxiety. However, they felt a sense of happiness after delivery. Before the application of UFP during the second stage of labour, midwives should explain to women the process of UFP application and what they can expect to happen; and where possible, and after explaining the procedure, midwives should get written permission before they apply the intervention during labour.
- Full Text:
- Date Issued: 2018
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