1.0 Introduction
1.1 Background of Study
In Nigeria, midwifery practice has developed alongside efforts to reduce high maternal mortality rates and improve maternal health indicators. The government and health organizations have invested in training midwives and expanding access to skilled birth attendants (Federal Ministry of Health Nigeria, 2015). The relationship between midwives and mothers during labour has long been recognized as a key factor influencing childbirth outcomes and maternal satisfaction. Historically, midwifery emerged as a profession dedicated to supporting women through childbirth with knowledge, skill, and empathy (Davis-Floyd, 2001). In many cultures, traditional birth attendants provided not only medical assistance but also emotional and cultural support, shaping positive birth experiences for mothers (Bohren et al., 2014).
With the institutionalization of childbirth and the rise of hospital-based deliveries in the 20th century, midwifery evolved into a more formalized and medicalized profession. However, this shift sometimes led to challenges in maintaining the compassionate and personalized care that characterized traditional midwifery (Kennedy et al., 2019). The attitude of midwives during labour has since become a focus of research globally, as it directly impacts maternal perceptions of care quality and willingness to utilize healthcare facilities for childbirth (Freedman et al., 2014).
According to Renfrew et al. (2014), the experience of labour is one of the most significant and vulnerable moments in a woman’s life, requiring not only skilled clinical care but also emotional support and respectful treatment. Midwives, as frontline caregivers during childbirth, are expected to provide holistic care that encompasses psychological needs of women in labour (Renfrew et al., 2014). The attitude of midwives during this period plays a vital role in shaping the mother’s childbirth experience and her perception of the healthcare system (Tunçalp et al., 2015).
Globally, respectful maternity care has gained increased attention as an essential component of quality maternal healthcare (WHO, 2019). Negative attitudes or behaviors from healthcare providers, including midwives, such as neglect, verbal abuse, or disrespect, have been widely reported and have been linked to adverse outcomes including psychological trauma, reduced trust in health services, and avoidance of facility births (Bowser & Hill, 2010; Freedman et al., 2014).
Okafor et al. (2020) asserted that, maternal mortality remains high, and one of the contributing factors is the reluctance of some women to utilize health facilities during childbirth, often attributed to negative perceptions of health workers’ attitudes (Okafor et al., 2020). Specifically, in Delta State, there is limited documented research focusing on post-natal mothers’ perceptions of midwives’ attitudes during labour, particularly in Central Hospital Sapele. Midwifery care plays a crucial role in ensuring safe and positive childbirth experiences. According to the World Health Organization (WHO, 2018), midwives are healthcare professionals who provide comprehensive care to women during pregnancy, labour, and the postpartum period, ensuring both maternal and neonatal wellbeing. The attitude of midwives during labour can significantly influence the mother’s perception of care, affect her psychological state, and impact the overall birth experience (Smith & Roberts, 2020).
Labour according to Bohren et al. (2017), is a critical and often stressful time for women, where compassionate and respectful care is essential (Bohren et al., 2017). The perception of post-natal mothers regarding midwives’ attitudes during labour reflects not only the quality of interpersonal interactions but also the emotional and psychological support provided (Afulani et al., 2019). Positive attitudes such as empathy, patience, and encouragement by midwives contribute to reduced anxiety and a more satisfying childbirth experience, whereas negative attitudes such as neglect, rudeness, or disrespect can lead to fear, dissatisfaction, and even avoidance of facility-based deliveries (Kassa et al., 2019). Therefore, this research study seeks to assess the perception of post-natal mothers about midwives’ attitudes during labour at Central Hospital Sapele, Delta State.
1.2 Statement of Problems
Investigation revealed that the attitude of midwives during labour is a critical factor influencing the childbirth experience and the overall perception of maternal healthcare services. Unfortunately, negative attitudes such as impatience, neglect, or disrespect by some midwives is often reported by post-natal mothers, leading to feelings of fear, anxiety, and dissatisfaction (Freedman et al., 2014). Such experiences is not only detrimental to the psychological well-being of mothers but also is a significant barrier to the utilization of skilled birth attendants and facility-based deliveries, especially in low-resource settings like Delta State (Okafor et al., 2020).
At Central Hospital Sapele, anecdotal evidence and informal reports suggest that some post-natal mothers perceive midwives’ attitudes during labour to be unfriendly or uncaring. This perception is concerning because it is likely to affect the trust mothers place in the healthcare system and their willingness to seek care in future pregnancies. When mothers feel disrespected or neglected during one of the most vulnerable moments of their lives, it is likely to create long-lasting negative impressions that undermines efforts to improve maternal and neonatal outcomes (Tunçalp et al., 2015).
Furthermore, cultural beliefs and expectations about childbirth experiences is unique in this region, which means that general findings from other parts of Nigeria or the world may not fully apply to this setting. It is against the backdrop that this study seeks to assess the perception of post-natal mothers about midwives’ attitudes during labour at Central Hospital Sapele, Delta State.
1.3 Aim and Objectives of Study
The aim of this study is to assess the perception of post-natal mothers about the attitude of midwives during labour at Central Hospital Sapele, Delta State. In achieving this aim, the following specific objectives were laid out as follows:
- To determine how post-natal mothers perceive the attitude of midwives during labour at Central Hospital Sapele.
- To identify specific behaviors exhibited by midwives that influence mothers’ perception during labour.
- To examine the relationship between midwives’ attitudes and mothers’ satisfaction with labour care.
- To explore the impact of midwives’ attitude on mothers’ willingness to use facility-based maternity services in the future.
- To recommend strategies for improving midwives’ attitude and enhancing respectful maternity care at Central Hospital Sapele.
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:
- How do post-natal mothers perceive the attitude of midwives during labour at Central Hospital Sapele?
- What specific behaviors of midwives influence mothers’ perceptions during labour?
- Is there a relationship between midwives’ attitudes and mothers’ satisfaction with the care received during labour?
- How does the attitude of midwives affect mothers’ willingness to use facility-based maternity services in the future?
- What strategies can be recommended to improve midwives’ attitudes and promote respectful maternity care at Central Hospital Sapele?
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.
- H0: There is no significant relationship between the attitude of midwives during labour and post-natal mothers’ perception of care at Central Hospital Sapele
- H1: There is no significant relationship between the attitude of midwives during labour and post-natal mothers’ perception of care at Central Hospital Sapele
1.6 Significance of Study
The outcome of this research will contribute to enhancing the quality of maternal healthcare services by promoting more respectful and compassionate care. Also, the study will assist policymakers in designing targeted training programs that focus on improving midwives’ interpersonal skills and attitudes, which will ultimately lead to better maternal satisfaction and improved health outcomes.
Furthermore, this research will add to the existing body of knowledge on maternal healthcare in Delta State and Nigeria at large, providing a foundation for further studies on respectful maternity care.
Lastly, the research study will empower women by giving voice to their childbirth experiences, emphasizing the importance of dignity and respect during one of the most critical moments of their lives.
1.7 Scope of Study
This study focuses on the perception of post-natal mothers regarding the attitude of midwives during labour at Central Hospital Sapele, located in Delta State, Nigeria. The research is limited to mothers who have recently delivered at this hospital and are within the post-natal period.
The scope is confined geographically to Central Hospital Sapele, a major public healthcare facility in Delta State, and does not include other hospitals or private maternity centers in the state.
1.8 Limitations of the Study
During the course of this study, there were some problems encountered which stood as limitations to the research work. Some of the limitations include:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
- Delay from Respondents: A particular limitation of this work came as a result of the respondent refusal to offer their cooperation at the initial time they were contacted. This contributed in making the success of this research study difficult.
- Response Bias: The study will involve surveys and interviews with cooperative managers and members. Response bias may occur if respondents provide socially desirable answers or if there is reluctance to disclose negative financial information due to privacy concerns or fear of repercussions.
1.9 Definition of Terms
Perception:
Perception refers to the way individuals interpret and make sense of their experiences and surroundings. In this study, it describes how post-natal mothers understand and feel about the attitudes and behaviors of midwives during labour. According to Ajzen (1991), perception shapes one’s response to situations and influences satisfaction with services received.
Post-Natal Mother:
A post-natal mother is a woman who has recently given birth and is in the period immediately following delivery, typically considered up to six weeks postpartum (World Health Organization, 2013). This phase is crucial for monitoring the health and wellbeing of both mother and newborn.
Midwife:
A midwife is a trained health professional who provides care and support to women during pregnancy, labour, delivery, and the post-natal period. Midwives play an essential role in ensuring safe childbirth and offering emotional and physical support (International Confederation of Midwives, 2019).
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