The Preterm Birth Rate in a Resource-Stricken Rural Area of the Limpopo Province, South Africa

Abstract

Background

Midwives play a pivotal role in providing primary prevention of preterm birth. Midwives screen and diagnose pre-existing medical conditions, manage all conditions as guided by their scope of practice and refer all cases to other relevant team members.

Purpose

The study aimed to determine and describe factors contributing to the escalating preterm birth rate in Limpopo, South Africa.

Methods

Descriptive survey was used to determine factors related to increased preterm births. The non-probability purposive sampling selected 55 midwives, and data were collected using self-administered questionnaires. Data were analyzed through SPSS version 23.

Results

Health facilities in Limpopo province had constrained resources as evidenced by a shortage of midwives, a lack of medical supply, poorly maintained, and old infrastructure. The skills of midwives and their working environment were affected by this constrained resource. The results from midwives that were perceived to affect them were 66% of participants reported lack of equipment, 29.1% participants agreed that pregnant women were presenting after 12 weeks to initiate antenatal care, while 45.3% pointed out they used steroids to prevent preterm labor. Record-keeping was viewed as an essential aspect to manage PTB when providing care. Despite the constrained resources, midwives were providing care to prevent PTB. This was evidenced by 78.2% agreeing that keep records from the first booking until the last antenatal visit, while 96.2% monitored the fetal heart rate, 98.1% screened for infections, and 90.9% referred all women at risk to the doctor. Thus, most of the midwives were competent with a confidence interval of (95%) and a prevalence of 9% and 9.5% that, is 9/10, which could prevent PTB.

Conclusion

Lack of resources, including staffing and specialized care, contributed to escalating PTB at health facilities in Limpopo province.

Graphical Abstract

Keywords:

• midwives
• maternal and neonatal care
• obstetric units
• preterm birth
• preterm death

Acknowledgments

Researchers acknowledge the midwives for participating in the study, the University of Venda for funding and providing the ethics certificate, and Limpopo Department of Health for providing the approval letter to access the obstetric units.

Disclosure

The authors declare that they had no financial or personal relationships, which may have inappropriately influenced them in writing this article.