Nursing and midwifery at the crossroads—new challenges, new successes

02 July 2014
Volume 22 · Issue 7


In April this year I was invited by Stellenbosch University in South Africa to conduct two workshops and give a keynote speech at their first International Nursing Conference. The title of the conference was Nursing and midwifery at the crossroads—new challenges, new successes. The conference was certainly a great success, with inspirational speakers and great presentations. These are three presentations which were given during the conference. As Kofi Annan once said ‘Knowledge is power. Information is liberating. Education is the premise of progress, in every society, in every family’. So I would like to share these with you, the speakers have given their permission.

Experiences of midwifery students in rendering the prevention of mother-to-child transmission programme in the Western Cape, South Africa

Walker SL, Van der berg LS


It is crucial to address shortcomings of the health systems if targets for the prevention of mother-to-child transmission (PMTCT) of HIV infection are to be achieved. Nurses are becoming central points of contact for care of people living with HIV and AIDS. It is therefore imperative for them to be adequately prepared to provide health care.

Problem statement

Various studies explored medical doctors', registered nurses', lay counsellors' and even patients' experiences concerning PMTCT. However, no studies were found in the available literature on students' experiences concerning the rendering of PMTCT care.

Aim and objective

The aim of this study was to gain an understanding of the experiences of undergraduate midwifery students rendering PMTCT services in health facilities. The objective is to describe and explore experiences of midwifery students in rendering PMTCT services.


A descriptive qualitative study was used to describe and explore the experiences of nursing students in rendering PMTCT services. Purposive sampling was used. All students studying a Midwifery course as part of an undergraduate university nursing programme in the first semester of 2012 were included. As part of their assessments students were asked to keep a reflective journal during their seven-week clinical placement. Content analysis was carried out using Atlas.ti 7, and data saturation was reached after 16 journals. Data were coded independently and compared.


Four themes emerged: knowledge, practice, attitude and emotions. These themes identified an important factor that, lack of knowledge significantly influenced the students' practices and attitudes as well as their emotions.

Conclusion and recommendations

This study contributes significant information for educators to assist and guide students for future clinical placement. The information will guide the educators towards planning more in-depth preparation of students for future clinical placement facilities for example, including all the core competencies of PMTCT in the orientation period.

Correspondence to: SL Walker

Sonja Lynn Walker Mcur, RN.NE, Lecturer Undergraduate Midwifery, School of Nursing, University of the Western Cape, Cape Town South Africa and Doctoral Student University of the Western Cape, Cape Town South Africa

Lindy van der Berg Mcur, RN, Lecturer Undergraduate Midwifery School of Nursing, University of the Western Cape, Cape Town South Africa,

What this adds to the literature.

This qualitative study provides information which can be used to formulate a curriculum for students in clinical placements. It is essential in all of midwifery aspects of midwifery that students are guided and supported. Although it is more significant in South Africa and HIV as HIV continues to be the leading indirect cause of maternal deaths.

Experiences and perceptions of pregnant women regarding health education given during the antenatal period

Zukiswa Signoria Mahlangeni


The availability and provision of good antenatal care services ensure early detection and prompt management of any complication or disease that may adversely affect pregnancy outcome. To ensure high quality care, an ongoing health education and empowerment of pregnant women with pregnancy related information, need to be provided by midwives throughout pregnancy.


The purpose of this study was thus to explore the pregnant women's experiences and perceptions regarding health education given during the antenatal period.

The objectives included to:

  • Explore the content of the health education given to pregnant women by midwives during the antenatal period
  • Determine whether the health education offered by midwives is understood by pregnant women
  • Determine whether information regarding Health Education during antenatal period is applicable and is used by pregnant women.
  • Research method

    A qualitative approach with an explorative descriptive design was applied. The population included pregnant women who attended an antenatal clinic for the second time. Ten pregnant women were selected purposively who consented to participate in the study.

    The trustworthiness of this study was assured by using Lincoln and Guba's criteria of credibility, transferability, dependability and confirmability. A pretest was done with one participant not included in the actual study. Ethics approval was obtained from the Ethics Committee of the Faculty of Medicine and Health Sciences at Stellenbosch University, reference: S12/05/136. Informed written consent was obtained from each participant which included a recording of the interview.

    Data were collected using an interview guide and a tape recorder. A total of 10 pregnant women were interviewed until data saturation was reached. The use of Tesch's eight steps of data analysis was used to analyse the transcribed data.


    Findings revealed that health education was given to pregnant women at the institution under study but with minimum explanations. Despite the fact that midwives was perceived as supportive and regarded as a source of information they emphasised non-pregnancy related complications specifically HIV/AIDS and neglected to give basic antenatal care, such as antenatal exercises, personal hygiene and diet. Language was found to be a barrier and contributed to a lack of information.

    Recommendations and Conclusion

    Recommendations include basic antenatal aspects to be covered in the health education, such as emphasis on personal hygiene, exercises, diet and avoidance of harmful sociocultural practices.

    In conclusion, to reduce maternal morbidity and mortality rates and promoting self-care reliance, antenatal care services should be accessible to facilitate ongoing health education by midwives throughout pregnancy.

    What this adds to the literature.

    This study highlights the importance which the midwife has in interactions with women. It supports the argument that all women despite age, race or language have the same needs and requirements and as midwives we should not make assumptions that women know what we do.

    Female Genital Modification (FGM): midwives guide to effective management during antepartum, intrapartum and the postpartum periods

    Doreen KM M'Rithaa


    Female genital mutilation (FGM), also known as female circumcision (FC) female genital cutting (FGC) and Female genital modification (FGM), are all terms used to refer to a traditional social practice of cutting or mutilating the external genitalia of girls or young women in order to keep up with the rites of passage into womanhood among some cultures not only in Africa but Asia. It occurs in more than 28 African and Asian communities at a rate of at least 50% in more than 60% of these countries. The highest incidence of highest incidence of FGM has been reported in Somalia (98%), Djibouti (98%), Eritrea (90%), Sierra Leone (90%), Sudan (85%), Egypt (80%) and Gambia (80%) according to (Hosken, 1993; Toubia, 1995).


    Women who undergo FGM do so with the need to be accepted within a social setting with the hope that they are elevated to a level of social status within which the specific culture dictates. However, they have unspoken experiences issues that emanate during pregnancy, birth and after birth such as; Fear and anxiety during pregnancy and childbirth; extreme pain and long-term complications; lack of health-care professionals' knowledge of circumcision which cause women to have bad experiences and increased maternal and neonatal mortality. Currently, there is little or no policies nationally that assist skilled birth attendants in the clinical areas to deal with women who have undergone FGM. This lack of direction emanates fear and anxiety among birth attendants resulting to mismanagement of these women.


    The aim of this presentation is to create the awareness of FGM, while suggesting proper management of these women during the antenatal intranatal and postnatal periods. The objectives include; giving a descriptive definition of FGM; identify the reasons for practicing FGM; discuss the antenatal, intranatal, and postnatal management of women who have undergone FGM.


    FGM changes a woman's life and should be identified and cautiously managed. Every woman is different therefore the healthcare workers need the attitude of being non-judgemental, positive and not condescending. There is need to gain the patients trust to help them deal with the long-term physical and psychological effects of the experience.

    Doreen KM M'Rithaa, Mcur, BNS, CRA, Lecturer Advanced Midwifery and Neonatal Nursing, Nursing Division Stellenbosch University, Cape Town South Africa and Doctoral Student: Cape Peninsula University of Technology, Cape Town, South Africa.

    What this adds to the literature.

    This presentation drew attention to the well-known problems of FGM. The presentation was very informative and provided extra information on Female Genital Modification.