Page 25 - Spring Graduation Booklet (SESSION-1)(19Oct2022)

SCHOOL OF NURSING & PUBLIC HEALTH
FACULTY OF HEALTH SCIENCES &
VETERINARY MEDICINE
DOCTOR OF PHILOSOPHY IN NURSING

CANDIDATE: MLAMBO Sarah

CANDIDATES’ DISSERTATION

A MODEL FOR MIDWIVES TOWARDS THE FACILITATION OF
CHILDBIRTH-CHOICES AMONG WOMEN IN SELECTED PUBLIC
HEALTHCARE FACILITIES IN NAMIBIA

The doctoral study was undertaken and completed under the supervision of Prof. Hans
Justus Amukugo as Main-Supervisor and Prof. Louise Pretorius as the Co-Supervisor, both
from the University of Namibia

Facilitation of childbirth-choices is critical in rendering patient centred care and for
women to make informed decisions regarding their mode of delivery. The rights of women
in ensuring decision making and affording women choices is vital for the emotional
wellbeing of the women and for positive birth experiences. The focus of the study was to
develop a model for midwives to assist the facilitation of childbirth-choices. In Phase one
of the study, a scoping review identified the best practices in the facilitation of childbirth-
choices; a qualitative approach with purposive sampling was adopted for the experiences
of midwives and women, and a quantitative approach with stratification was applied
to identify the different childbirth types in selected healthcare facilities. Qualitative
data were analysed through the six steps proposed by Creswell, and quantitative data
were analysed through SPSS (version 26). The scoping review revealed that facilitation
of childbirth-choices should include shared decision making, patient centred care, the
implementation of protocols and guidelines at all levels, informed consent or choice
and the provision of unbiased information. Midwives articulated barriers in the facilitation
of childbirth-choices by expressing shortages of staff, timing of information, information
sharing as well as cultural influences. Furthermore, midwives shared that lack of provision
for childbirth-choices as the rights of women were not observed and a lack of women-
centred care despite protocols and guidelines which are not adhered to. Moreover,
women in this study affirmed that they had inadequate information about the childbirth
types and were unsure and or surprised that they had choices, and they lacked shared
decision making with regards to childbirth-choices.

In conclusion, a model was developed and described (Phase three) based on the
study findings to help in the facilitation of childbirth-choices among women. The
developed model was evaluated following the considerations by Fawcett. Guidelines
to operationalise the model (Phase four) were developed as guided by the study results.

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