This study was conducted in Lebanon with the main objectives of
acquiring baseline data on practices and routines applied in the
obstetrics ward for women having normal delivery; estimating the
frequency of certain practices; and assessing whether women are given
choice in these practices. A national sample of 39 hospitals was
selected. The director, head midwife, or head nurse of the obstetrics
department was interviewed using a semi-structured questionnaire.
The hospitals studied are largely equipped to cope with emergencies and
services are available 24 hours a day. On average, the caesarean section
rate is 18% and the stillbirth rate is 10 per 1000, but with
considerable variability between facilities. The majority of hospitals
do not have written policies or standard birth procedures and lack
mechanisms for evaluation. Generally, minimal prenatal information is
given to women. Companions are allowed during labour but this access is
more restricted in delivery. The reported configuration of professional
care during labour and delivery is favourable to high quality care. In
terms of mobility during labour, most hospitals allow women to move.
However, 31 hospitals set an i.v. drip to all women and some use
continuous fetal monitoring method. Mobility is restricted in delivery;
in 23 hospitals women are tied down. Nearly all hospitals give
intra-muscular anaesthesia whereas epidurals are used less frequently.
As for postpartum care, most hospitals do not initiate breastfeeding
within one hour of birth and few have rooming in. The majority of
hospitals do not provide women with family planning methods and a few do
not even discuss methods with them.
The approach used in this study constitutes a tool for understanding and
assessing maternity services that should be applied in other settings.
The tool is available from the authors.
Khayat, R.; Campbell, O. Hospital practices in maternity wards in Lebanon. Health Policy and Planning (2000) 15 (3) 270-278. [DOI: 10.1093/heapol/15.3.270]
Hospital practices in maternity wards in Lebanon