1.0 Introduction
1.1 Background of Study
The management of labor is a critical aspect of maternal care, as it directly influences both maternal and neonatal outcomes. Midwives, as primary healthcare providers during childbirth, are responsible for overseeing the labor process, providing emotional support, and identifying complications that may require medical intervention. Their ability to manage labor effectively is influenced by their training, experience, and available resources (Tuncalp et al., 2015). However, despite their vital role, many midwives work in challenging environments where inadequate training, outdated practices, and a lack of resources can hinder their ability to provide optimal care (World Health Organization, 2018).
The Labour Care Guide (LCG) training was developed to address these gaps by equipping midwives with updated, evidence-based guidelines and skills to improve labor management, especially in low-resource settings. The LCG is structured to promote a standardized approach to care, emphasizing the importance of active management of labor, respectful care, and timely interventions when complications arise (McClure et al., 2015). The training has been shown to improve midwives' clinical skills, enhance their decision-making abilities, and foster a greater sense of confidence in managing labor effectively (Hassan et al., 2019).
Previous studies have demonstrated that midwives who receive structured training in labor management tend to be more confident in their skills, leading to better decision-making and improved maternal and neonatal outcomes (Melek et al., 2017). However, the extent to which specific training programs like the LCG influence midwives' practice in different healthcare settings remains an under-researched area. Given the increasing demand for skilled midwives and the need for evidence-based practices in childbirth management, it is essential to evaluate the perceived impact of such training on midwives' skills and confidence.
According to World Health Organization (2018), a labour care guide refers to a structured framework or set of evidence-based guidelines developed to aid midwives in providing optimal care during childbirth. It outlines best practices for managing labor and delivery, with an emphasis on patient safety, effective communication, and skill development (World Health Organization [WHO], 2018). The quality of labor management is essential in ensuring positive outcomes for both the mother and the baby. Midwives, as key healthcare providers in maternal and childbirth care, play a pivotal role in managing labor and ensuring the safety and well-being of pregnant women during delivery. However, the efficacy of midwives in providing care is often influenced by their training and the resources available to them. One such training initiative is the Labour Care Guide (LCG) training, which aims to enhance midwives' skills and boost their confidence in managing labor.
The Labour Care Guide training is designed to provide midwives with evidence-based guidelines and practical skills necessary for improving the quality of care during labor. The training focuses on the management of normal labor, identifying complications early, and providing supportive care to women in labor (McClure et al., 2015). It is crucial to explore the impact of such training on midwives' skills and their level of confidence in labor management. Research has shown that appropriate training can positively influence the ability of healthcare providers to respond effectively to labor complications, thereby improving maternal and neonatal outcomes (World Health Organization, 2018). However, despite the importance of such training programs, limited studies have investigated how the Labour Care Guide training specifically affects midwives in various healthcare settings. Therefore, in Nigeria where the research was carried out, the activities that was conducted is to explore the perceived impact of Labour Care Guide training on midwives' skills and confidence in managing labor, with a particular focus on the outcomes in practice.
1.2 Statement of Problems
Investigation revealed that the midwives often lack the necessary skills and confidence to manage complex labor situations, leading to delays in interventions, unnecessary complications, and sometimes preventable maternal and neonatal deaths. The absence of standardized guidelines for labor care further exacerbates the problem, as midwives are left to rely on their own experience or outdated practices, which may not be aligned with current evidence-based recommendations.
Furthermore, the introduction of the Labour Care Guide (LCG) training is designed to address these challenges by providing midwives with a structured, evidence-based framework for managing labor. However, it is unclear whether the implementation of this training is sufficiently impacting midwives' skills and confidence in labor management. In many healthcare settings, there is limited data on how such training programs influence midwifery practice, especially in resource-constrained environments.
The problem is compounded by the lack of studies specifically examining how the Labour Care Guide training influences midwives' skills and confidence in managing labor in various clinical settings. Without a clear understanding of the impact of this training, it is difficult to make informed decisions about its widespread implementation and improvement. It is against the backdrop that this study seeks to address these problems by evaluating the perceived impact of the Labour Care Guide training on midwives' abilities and their self-assurance in managing labor, with the aim of improving labor outcomes in the long term.
1.3 Aim and Objectives of Study
The aim of the study is to assess the perceived impact of Labour Care Guide (LCG) training on midwives' skills and confidence in labor management. The specific objectives of the study are:
- To identify any challenges faced by midwives during the LCG training and in applying the knowledge gained in their practice.
- To determine whether the LCG training has led to improvements in the quality of care provided during labor and delivery.
- To explore midwives' perceptions of the effectiveness of the LCG training in enhancing their skills and confidence.
- To evaluate midwives' skills in labor management before and after the Labour Care Guide (LCG) training.
- To assess the level of confidence among midwives in managing labor after completing the LCG training.
- To provide recommendations for improving the training program based on the findings of the research study.
1.4 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- Are there challenges faced by midwives during the Labour Care Guide (LCG) training and in applying the acquired skills in clinical practice?
- How do midwives' skills in labor management change after completing the Labour Care Guide (LCG) training?
- To what extent does the Labour Care Guide (LCG) training enhance midwives' confidence in managing labor?
- In what ways has the Labour Care Guide (LCG) training improved the quality of care provided by midwives during labor and delivery?
- What are midwives' perceptions of the effectiveness of the Labour Care Guide (LCG) training in enhancing their skills and confidence?
- How can the Labour Care Guide (LCG) training program be improved to better support midwives in their labor management practice?
1.5 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There is no significant difference in the skills and confidence of midwives in managing labor before and after undergoing Labour Care Guide (LCG) training.
- H1: There is a significant difference in the skills and confidence of midwives in managing labor before and after undergoing Labour Care Guide (LCG) training.
Hypothesis Two
- H0: Midwives who undergo Labour Care Guide (LCG) training will not show a significant improvement in their skills and confidence in managing labor compared to those who do not undergo the training.
- H1: Midwives who undergo Labour Care Guide (LCG) training will show a significant improvement in their skills and confidence in managing labor compared to those who do not undergo the training.
1.6 Significance of Study
The outcome of the research findings will contribute to the enhancement of training curricula for midwives, ensuring that they are better equipped to handle various labor scenarios. Moreover, it will promote the integration of standardized guidelines into midwifery practice, improving maternal and neonatal outcomes.
This research will also provide evidence to policymakers and healthcare administrators on the need for continuous professional development programs for midwives.
Ultimately, the study will aid in fostering a more competent and confident workforce, leading to safer and more efficient labor management in healthcare facilities.
1.7 Scope of Study
The scope of this study will be limited to midwives working in selected public and private healthcare facilities in Lagos State, Nigeria. It will focus on midwives who have undergone Labour Care Guide (LCG) training, aiming to assess its impact on their skills and confidence in labor management. The research will exclude midwives in regions outside Lagos State, as well as those who have not participated in Labour Care Guide training programs.
1.8 Limitations of the Study
The study was constrained by financial and time limitations, which affected the ability to extend the research to a broader range of facilities and included only those midwives who had undergone Labour Care Guide (LCG) training in the past few years.
Additionally, there was a challenge in obtaining precise data on the length and frequency of the training received by the midwives, which could have influenced their skills and confidence levels. Furthermore, power failure and internet connectivity issues in certain areas caused delays in data collection and communication.
1.9 Definition of Terms
In the context of this study, several key terms are important to define for clarity and understanding:
Labour Care Guide:
A labour care guide refers to a structured framework or set of evidence-based guidelines developed to aid midwives in providing optimal care during childbirth. It outlines best practices for managing labor and delivery, with an emphasis on patient safety, effective communication, and skill development (World Health Organization [WHO], 2018).
Midwives:
Midwives are trained professionals who specialize in assisting women during childbirth, providing prenatal and postnatal care, and supporting women in their reproductive health. They play a crucial role in managing normal deliveries and are skilled in recognizing complications that may require medical intervention (International Confederation of Midwives [ICM], 2020).
Skills:
Skills, in the context of this study, refer to the practical competencies and techniques that midwives acquire and apply during labour and delivery. These may include physical tasks like monitoring fetal heart rate, managing labor progress, and performing emergency interventions (Anderson et al., 2019).
Confidence:
Confidence refers to a midwife's belief in her ability to handle labor and delivery situations competently. This emotional state can significantly impact decision-making and the quality of care provided, as confident midwives are more likely to make timely decisions and provide optimal care (Brown & Ferguson, 2017).
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