INTRODUCTION

Background of the Study

Maternal death is always a great tragedy. Apart from being a lost

to the family and the community the child is deprived of maternal love

and care. Herz and Meashan (1987) revealed that children thrive and

learn more when their mothers are with them. Maternal death arising

from child bearing exert a heavy needless on women and their families

in most of the developing countries.

A great majority of maternal deaths are preventable due to

technology and education now available yet maternal deaths even

when one consider all the personal loss of family experience are small

portion of the problems compared with what pregnant women faces.

The Lewis & Dripe International Classification of Disease Injuries

and Causes of Death (2005) defines maternal death as the death of a

woman while pregnant or within 42 days of delivery miscarriage or

termination of pregnancy from any cause related to or aggravated by

the pregnancy or its management but not from accidental or incidental

causes. World Health Organization (WHO) estimates that at least

600000 women die every year from pregnancy related causes though

the rate is difficult to estimate accuracy (Clark 2002). Whereas the life

time risk of maternal death for a woman in a developed country is 1 in

1800 in Africa. It is 1 in 16 in Asia 1 in 65 and in Latin America 1 in 130

(Who 1998). The global causes of maternal death are harmorrhage

infection (puerperial sepsis) obstructed labour eclampsia and the

consequences of the safe abortion. The safe motherhood initiative was

originated to address the scandalous loss of maternal life but has little

impact on outcomes although awareness has been highlighted. More

recently WHO (2002) has launched the initiative making pregnancy

safer (MPS) which addresses three target:

● Prevention and management of unwanted pregnancy and unsafe abortion

● Skilled care during pregnancy and child birth

● Access to referral care when complication arise

All these are of direct concern to midwives and their practice

(Bannede & Lyander 2003).

The life saving techniques in use at Kafanchan General Hospital

are as follows:

a) Living oxytocin with delivery of the anthrax should

b) Early clamping and cutting of the cord

c) Nipple stimulation usually with breast feeding

d) Giving episiotomy to prevent ragged tear

e) Assisted delivery of the placenta through controlled cord

traction while supporting or holding the contracted uterus

(Dr. A. A. Adeyemi 2005).

The Major Causes of Maternal Mortality in Kafanchan

General Hospital are:

● Post partum haemorrhage

● Infection (puerperial sepsis)

● Obstructed labour

Post Partum Haemorrhage: is defined as excessive bleeding

from the genital tract at any time following child birth up to six

weeks after delivery.

Puerperial Sepsis is defined as an infection or the genital tract

which occurs as a complication of delivery.

Obstructed Labour is refers to a situation in which the descent

of the presentation is arrested despite good and efficient uterine

contraction.

The Life Saving Practice that could be Adopted to Prevent

Maternal Mortality

i) Giving 1.m (intramuscular injection) which is oxytocin 10IU

and ergometrin 0.5ml this will be given at the delivery of the

anterior shoulder of the baby.

● This hasten the separation of placental

● It aid in contraction of the uterine muscles and also

prevent post-partum haemorrhage in 3rd stage of labour

ii) Using aseptic method in conducting delivery and sterilization

of instrument used properly. This is the most safest and

more effective method for processing instrument that come

in contact with blood the tissue beneath the skin or tissue

which are normally stream

Statement of the Problem

The current status of maternal mortality in General Hospital

Kafanchan going by delivery record of (2006-2008) shows that 38

women out of the 4320 women that delivered died representing

approximately 13%. Most of these cases were as a result of:

● Post partum haemorrhage

● Obstructed labour

● Infection (puerperial sepsis)

The correction of labour room management is that most of these

women came in when complication had occurred and such women use

to be brought already in stock state.

The ideal method of handling maternal mortality is that any

woman who have been diagnosed of post partum haemorrhage and

obstructed labour right from antenatal usually come to the labour room

as soon as labour established so that all other medical teams can be

called in case if she cannot deliver per vaginal so as to deliver her safely

and her baby and to prevent such complication.

Due to these reasons the researcher have chosen to find out a way

on how these can be prevented

Purpose of the Study

i) To examine the management techniques of post partum

haemorrhage used by midwives in Kafanchan General Hospital

ii) To ascertain the management techniques of obstructed labour

used by midwives in Kafanchan General Hospital

iii) To identify the management techniques of puerperial sepsis used

by midwives in Kafanchan General Hospital.

Research Questions

i) What are the post partum haemorrhage (PPH) management

technique used by midwives in Kafanchan General Hospital?

ii) What are the obstructed labour management technique used by

midwives in Kafanchan General Hospital?

iii) What are the puerperial sepsis management techniques used by

midwives used in Kafanchan General Hospital?

Significance of the Study

This study will be significant to midwives at Kafanchan General

Hospital. Findings from the study will prove useful information to

midwives on how to safeguard against frequent maternal mortality. The

community will be encourage to make good use of medical facilities even

as the antenatal unit this will also be useful to government of kaduna

state as the findings of the research will provide information on the

causes of maternal mortality amongst childbearing women “how it can

be prevented and create more awareness for people in regards to

maternal death.

It is hoped that the knowledge acquired from the study will also

provide necessary motivation for further researchers who might be

interested in similar study.

Scope of the Study

The research work will be conducted at Kafanchan General

Hospital from 2006-2008. This area was chosen for easy assess to

statistical document from the record department that can guide the

researcher.