Table 4.
Maternal and newborn interventions and health outcomes (labour observation)
| Ghana (n=926) | Guinea (n=682) | Nigeria (n=408) | Total (n=2016) | ||
|---|---|---|---|---|---|
| Maternal interventions | |||||
| Induction of labour | 237 (25·6%) | 25 (3·7%) | 16 (3·9%) | 278 (13·8%) | |
| Augmentation of labour | 529 (57·1%) | 401 (58·8%) | 196 (48·0%) | 1126 (55·9%) | |
| Perineal shaving | 82 (8·9%) | 7 (1·0%) | 36 (8·8%) | 125 (6·2%) | |
| Enema | 1 (0·1%) | 11 (1·6%) | 0 | 12 (0·6%) | |
| Perineal tear | |||||
| First-degree tear | 232 (25·1%) | 86 (12·6%) | 57 (14·0%) | 375 (18·6%) | |
| Second-degree tear | 72 (7·8%) | 11 (1·6%) | 15 (3·7%) | 98 (4·9%) | |
| Third-degree or fourth-degree tear | 17 (1·8%) | 1 (0·1%) | 2 (0·5%) | 20 (1·0%) | |
| Perineal repair or suture performed* (n=118) | 87 (97·8%) | 11 (91·7%) | 15 (88·2%) | 113 (95·8%) | |
| Local anaesthetic used during perineal repair (n=113) | 78 (89·7%) | 10 (90·9%) | 9 (60·0%) | 97 (85·8%) | |
| Maternal health outcomes | |||||
| Birth position (for women with non-instrumental vaginal birth, n=1572) | |||||
| Dorsal or supine | 295 (42·8%) | 519 (97·7%) | 314 (89·2%) | 1128 (71·8%) | |
| Lithotomy | 384 (55·7%) | 8 (1·5%) | 37 (10·5%) | 429 (27·3%) | |
| On all fours | 0 | 1 (0·2%) | 0 | 1 (0·1%) | |
| Squatting or sitting | 3 (0·4%) | 3 (0·6%) | 0 | 6 (0·4%) | |
| Lying on her side | 6 (0·9%) | 0 | 0 | 6 (0·4%) | |
| Other or unknown | 1 (0·2%) | 0 | 1 (0·3%) | 2 (0·1%) | |
| Mode of childbirth | |||||
| Non-instrumental vaginal birth | 689 (74·4%) | 531 (77·9%) | 352 (86·3%) | 1572 (78·0%) | |
| Instrumental vaginal birth (vacuum or forceps) | 71 (7·7%) | 27 (4·0%) | 10 (2·5%) | 108 (5·4%) | |
| Caesarean section | 143 (15·4%) | 92 (13·5%) | 26 (6·4%) | 261 (12·9%) | |
| Maternal admission to intensive care† | 36 (3·9%) | 14 (2·1%) | 16 (3·9%) | 66 (3·3%) | |
| Maternal transfer to another hospital† | 3 (0·3%) | 3 (0·4%) | 7 (1·7%) | 13 (0·6%) | |
| Maternal discharge† | |||||
| No | 908 (98·1%) | 604 (88·6%) | 390 (95·6%) | 1902 (94·3%) | |
| Yes | 0 | 49 (7·2%) | 5 (1·2%) | 54 (2·7%) | |
| Maternal status at end of observation† | |||||
| Alive | 907 (97·9%) | 652 (95·6%) | 394 (96·6%) | 1953 (96·9%) | |
| Dead | 2 (0·2%) | 3 (0·4%) | 0 | 5 (0·2%) | |
| Newborn health outcomes | |||||
| Singleton or multiple birth | |||||
| Singleton (1 baby) | 894 (96·5%) | 632 (92·7%) | 397 (97·3%) | 1923 (95·4%) | |
| Multiple (set of twins) | 18 (1·9%) | 23 (3·4%) | 10 (2·5%) | 51 (2·5%) | |
| Unknown, don't know, or missing | 14 (1·5%) | 27 (4·0%) | 1 (0·2%) | 42 (2·1%) | |
| Sex of the baby (2025 babies)‡ | |||||
| Female | 438 (47·1%) | 315 (46·5%) | 199 (47·7%) | 952 (47·0%) | |
| Male | 485 (52·2%) | 361 (53·2%) | 218 (52·3%) | 1064 (52·5%) | |
| Unknown | 7 (0·8%) | 2 (0·3%) | 0 | 9 (0·4%) | |
| Baby status at birth (2025 babies)‡ | |||||
| Baby alive at birth | 919 (98·8%) | 642 (94·7%) | 392 (94·0%) | 1953 (96·4%) | |
| Fresh stillbirth§ | 3 (0·3%) | 24 (3·5%) | 4 (1·0%) | 31 (1·5%) | |
| Macerated stillbirth¶ | 5 (0·5%) | 11 (1·6%) | 3 (0·7%) | 19 (0·9%) | |
| Unknown, don't know, or missing | 3 (0·3%) | 1 (0·1%) | 18 (4·3%) | 22 (1·1%) | |
| Baby status at end of observation period (1953 babies alive at birth) | |||||
| Baby admitted to special care baby unit | 124 (13·5%) | 14 (2·2%) | 53 (13·5%) | 191 (9·8%) | |
| Very early infant death (birth up to 2 h post partum) | 15 (1·6%) | 17 (2·6%) | 12 (3·1%) | 44 (2·3%) | |
See appendix (pp 9–10) for extended version.
*
Among women with second, third, or fourth degree perineal tears.
†
At up to 2 h post partum (end of observation period).
‡
Number of babies per country: Ghana, n=930; Guinea, n=678; Nigeria, n=417.
§
Stillbirth occurring in the intrapartum period.
¶
Stillbirth probably occurring more than 12 h before birth.