title: Routine care of women experiencing normal deliveries in Zambian maternity wards: a pilot study.
abstract: OBJECTIVE
  To describe the routine care of women during normal labour and delivery, and the immediate care of newborn babies in Zambia at different levels of health care.
  
  
  METHODS
  A descriptive survey carried out between July 1994 and January 1995.
  
  
  METHODS
  Eleven maternity facilities, one University teaching hospital, two urban health centres and eight rural hospitals in one province in Zambia.
  
  
  METHODS
  Eighty-four women in normal childbirth and their babies studied from admission to the labour ward until time of discharge from the labour ward.
  
  
  RESULTS
  Observations related to the care of the women during normal labour and delivery, and the immediate care of the baby. The findings show that women were confined to bed during the whole labour and delivery period, food and drinks were withheld, and no gowns were provided. None of the women were allowed to have a companion present during labour. Fetal monitoring was inconsistent and the partograph was either not used or partly lacking. All women were delivered in a lithotomy position and primiparae were fixed in stirrups during the second and third stages of labour. There was general lack of support for early mother/baby contact, prevention of hypothermia in the babies and early initiation of breast feeding.
  
  
  CONCLUSIONS
  Based on our findings we suggest that many present maternity ward routines, both physiological and psychological, should be carefully studied. It is also suggested that the midwives reorient their caring practices to more culturally and evidenced-based maternity care. Refresher courses for midwives who have been working for many years are recommended.
authors.affiliation: Lusaka School of Nursing, Zambia.
authors.forename: M C
authors.initials: MC
authors.lastname: Maimbolwa
authors.forename: A B
authors.initials: AB
authors.lastname: Ransjö-Arvidson
authors.forename: N
authors.initials: N
authors.lastname: Ng'andu
authors.forename: N
authors.initials: N
authors.lastname: Sikazwe
authors.forename: V K
authors.initials: VK
authors.lastname: Diwan
mesh_terms: D000293:Adolescent; D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008427:Maternal Health Services; D016389:Maternal-Child Nursing / Q000379:methods*; D010865:Pilot Projects; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D015024:Zambia