title: Quality of intra-partum care at a university hospital in Nepal: A prospective cross-sectional survey.
abstract: OBJECTIVE
  To investigate the quality of intra-partum care provided to women with an expected normal birth at a university hospital in Nepal.
  
  
  METHODS
  A prospective cross-sectional study was conducted during three weeks in November 2013. Nurses at the labor ward collected data from 292 consecutive births. Of these, 164 women of low risk were expected to have a normal birth and were included in the study; 107 (65%) were nulliparous. The self-administered questionnaire covered maternal characteristics, previous pregnancies and births, current pregnancy, labor and birth. Nine items assessed care management, five of which comprised the Bologna score with a total possible score of 5: presence of a companion, use of partograph, non-use of augmentation, non-supine position, and skin-to-skin contact.
  
  
  RESULTS
  The women were assisted by physicians (56%), nurses (42%) or students under supervision (2%). All were in good health after birth. Two had a postpartum hemorrhage exceeding 500 ml and 49% had an episiotomy. Apgar score in all neonates was ≥ 7 at five minutes. Mean Bologna score was 1.43 (variance 0-3).
  
  
  CONCLUSIONS
  The management of care in normal birth could be improved in the studied setting, and there is a need for more research to support such improvement.
authors.affiliation: Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, P.O. BOX 457, SE 405 30 Gothenburg, Sweden. Electronic address: johanna.cederfeldt@gmail.com.
authors.forename: Johanna
authors.initials: J
authors.lastname: Cederfeldt
authors.affiliation: Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, P.O. BOX 457, SE 405 30 Gothenburg, Sweden.
authors.forename: Jenny
authors.initials: J
authors.lastname: Carlsson
authors.affiliation: Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, P.O. BOX 457, SE 405 30 Gothenburg, Sweden; School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland.
authors.forename: Cecily
authors.initials: C
authors.lastname: Begley
authors.affiliation: Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, P.O. BOX 457, SE 405 30 Gothenburg, Sweden; Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.
authors.forename: Marie
authors.initials: M
authors.lastname: Berg
mesh_terms: D000328:Adult; D001034:Apgar Score; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000592:standards*; D004841:Episiotomy / Q000706:statistics & numerical data; D005260:Female; D006785:Hospitals, University / Q000592:standards*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007743:Labor, Obstetric; D008427:Maternal Health Services / Q000592:standards*; D009390:Nepal / Q000453:epidemiology; D010298:Parity; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D011247:Pregnancy; D011446:Prospective Studies; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Bologna score; Intra-partum care; Nepal; Quality of health care; Survey