Date of Award

12-2023

Degree Type

Thesis

Degree Name

Master of Science in Advanced Practice Midwifery (MSc-APM)

First Advisor

Dr. Abednego Ongeso

Second Advisor

Dr. Eva Maina

Third Advisor

Prof Eunice Ndirangu

Department

School of Nursing and Midwifery, East Africa

Abstract

Background: Labour to delivery is a natural process which begins and ends spontaneously. However, the need for an emergency caesarean section arises if the life of the mother or the foetus or both are in danger. Time is of essence and therefore a Decision to Delivery Interval of 30 minutes is considered the gold standard (NICE 2021).

Purpose: The purpose of this study was to establish hospital and client related factors that cause delay in emergency caesarean sections in Machakos County Referral Hospital.

Methodology: A Retrospective Descriptive study design was adopted whereby sample of 368 files of women who underwent an emergency CD in January to December 2019 were reviewed. A data abstraction tool was used to collect the quantitative data. Analysis was done using SPSS version 25. Significance level was at p < 0.05, with a confidence interval of 95%. Data was presented in form of tables, figures, and in prose.

Results: The results showed that the mean age was 25-34 years, and the proportion of emergency caesarean sections was 25.3% (n=2190). The average DDI was 192.3 minutes and only 25/368 (7%) met the ideal DDI of 30 minutes. There was no association between client related factors and the Decision to delivery interval. Hospital related factors had a contribution to delay at 54.6% followed by blood investigations at 39.4% and Doctors at 12.2%. Chi square analysis showed an association between inadequate theatre space, blood investigations and decision to delivery interval at a p value of 0.000.

Conclusion: Client related factors did not affect the DDI significantly. Hospital related factors had a significant affect with inadequate theatre space contributing highly to delay, followed by blood investigations.

First Page

1

Last Page

93

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