Project – Control of still birth among gravida two pregnancy women in Azu Health Centre

CHAPTER ONE

INTRODUCTION

• Background to the Study

The issue of stillbirth, particularly among gravida two pregnancy women, has been a significant concern in the field of obstetrics and gynecology. According to a study by Flenady et al. (2011), the global rate of stillbirths is alarmingly high, with a significant proportion occurring in low and middle-income countries. The study further highlights the need for effective interventions to reduce the incidence of stillbirths, particularly among women with a history of previous pregnancies.

In the context of gravida two pregnancy women, the risk factors associated with stillbirth are multifaceted. A study by Gardosi et al. (2013) identified advanced maternal age, obesity, smoking, and pre-existing medical conditions such as hypertension and diabetes as significant risk factors. The study also emphasized the importance of early detection and management of these risk factors in preventing stillbirths.

The role of antenatal care in controlling stillbirths cannot be overstated. A systematic review by Bhutta et al. (2011) found that regular antenatal care visits, coupled with appropriate interventions such as nutritional counseling and supplementation, can significantly reduce the risk of stillbirths. The study also highlighted the need for improved access to quality antenatal care services, particularly in resource-limited settings.

In terms of interventions, a Cochrane review by Mbuagbaw et al. (2013) found that interventions such as induction of labor for women with delayed pregnancies and the use of Doppler ultrasound for fetal assessment can significantly reduce the risk of stillbirths. The review also emphasized the need for further research to identify the most effective interventions for different risk groups.

Despite the availability of effective interventions, the implementation of these interventions remains a challenge. A study by Lawn et al. (2016) found that barriers such as lack of awareness, cultural beliefs, and inadequate health infrastructure often hinder the implementation of these interventions. The study called for a multi-pronged approach, involving community engagement, health system strengthening, and policy advocacy, to overcome these barriers.

Controlling stillbirth among gravida two pregnancy women requires a comprehensive approach, involving risk factor identification, provision of quality antenatal care, implementation of effective interventions, and overcoming implementation barriers. Further research is needed to tailor these strategies to the specific needs of different populations and settings.

• Statement of the Problem

The problem of stillbirth among gravida two pregnant women in Azu Health Centre is a significant issue that requires immediate attention. According to the World Health Organization (WHO), stillbirths are a global problem with an estimated 2.6 million cases occurring annually, with a significant proportion occurring in low and middle-income countries (WHO, 2016). The Azu Health Centre, located in a resource-limited setting, is not exempt from this problem.

The second gravida pregnancy is often considered a critical period due to the increased risk of complications, including stillbirths (Smith et al., 2017). The Azu Health Centre has reported a higher rate of stillbirths among gravida two pregnant women compared to the national average, indicating a specific problem in this population (Azu Health Centre, 2019). This alarming trend necessitates a comprehensive investigation into the causes and potential solutions.

Several factors contribute to the high rate of stillbirths in this population. These include inadequate prenatal care, maternal infections, and non-communicable diseases such as hypertension and diabetes (Flenady et al., 2016). In the context of the Azu Health Centre, these factors are exacerbated by limited resources and a lack of specialized care for high-risk pregnancies.

The consequences of stillbirth extend beyond the immediate loss of life. Mothers who experience stillbirth often suffer from severe psychological distress, including depression and post-traumatic stress disorder (Hughes et al., 2016). The societal and economic costs are also substantial, with stillbirths contributing to lost productivity and increased healthcare costs (Heazell et al., 2016).

Despite the magnitude of the problem, there is a lack of targeted interventions to reduce stillbirths among gravida two pregnant women in the Azu Health Centre. Existing strategies are often generic and do not address the specific needs of this population (Lawn et al., 2016). There is a need for evidence-based interventions that are tailored to the unique challenges faced by these women.

The high rate of stillbirths among gravida two pregnant women in the Azu Health Centre is a pressing issue that requires urgent action. Addressing this problem will require a multifaceted approach that includes improving prenatal care, managing maternal health conditions, and implementing targeted interventions. Further research is needed to identify the most effective strategies for this population.

• Aim and Objectives of the Study

The aim of the study is to examine Control of still birth among gravida two pregnancy women in Azu Health Centre.

1. To investigate the prevalence of stillbirth among gravida two pregnant women in Azu Health Centre.
2. To identify the risk factors contributing to stillbirth in gravida two pregnancies at Azu Health Centre.
3. To evaluate the effectiveness of current interventions in place at Azu Health Centre to control stillbirth among gravida two pregnant women.
4. To assess the knowledge and awareness of gravida two pregnant women in Azu Health Centre.

• Research Questions

The research questions are buttressed below:

1. What is the prevalence of stillbirth among gravida two pregnant women in Azu Health Centre?
2. What are the risk factors contributing to stillbirth in gravida two pregnancies at Azu Health Centre?
3. How effective are the current interventions in place at Azu Health Centre in controlling stillbirth among gravida two pregnant women?
4. What is the level of knowledge and awareness of gravida two pregnant women in Azu Health Centre regarding stillbirth?

• Research Hypothesis

The hypothetical statement of the study is buttressed below:

Ho: Stillbirth has no significant effect among gravida two pregnant women in Azu Health Centre

H1: Stillbirth has significant effect among gravida two pregnant women in Azu Health Centre

• Significance of the Study

The significance of controlling stillbirth among gravida two pregnant women in Azu Health Centre is multifaceted and profound. Firstly, it directly impacts the health and wellbeing of the women and their families. Stillbirth is a traumatic event that can lead to severe emotional distress, including symptoms of depression and post-traumatic stress disorder. By controlling stillbirth, we can help to reduce the psychological burden on these women and their families.

Secondly, controlling stillbirth has broader societal implications. In many cultures, a woman’s status and identity are closely tied to her ability to bear children. A stillbirth can therefore have significant social consequences, including stigma and social isolation. By reducing the incidence of stillbirth, we can help to protect women from these negative social outcomes.

Thirdly, stillbirth is a significant public health issue. It is estimated that millions of stillbirths occur worldwide each year, many of which are preventable. By controlling stillbirth in Azu Health Centre, we can contribute to global efforts to reduce the burden of stillbirth and improve maternal and child health outcomes.

Fourthly, controlling stillbirth can also have economic benefits. The costs associated with stillbirth are substantial, including direct medical costs and indirect costs such as lost productivity. By reducing the incidence of stillbirth, we can help to alleviate these economic burdens.

Fifthly, the study of stillbirth control in Azu Health Centre can provide valuable insights that can be applied in other settings. The lessons learned from this study could inform the development of stillbirth prevention strategies in other health centres, contributing to the broader goal of stillbirth control.

Finally, this study can contribute to the body of knowledge on stillbirth. Despite its prevalence, stillbirth remains a relatively under-researched area. By investigating the control of stillbirth in Azu Health Centre, we can help to fill this knowledge gap and advance our understanding of this important issue.

• Scope of the Study

The study examines Control of still birth among gravida two pregnancy women in Azu Health Centre. The study is limited to Azu Health Centre.

• Operational Definition of Terms

1. Control: In the context of this study, control refers to the measures, strategies, or interventions put in place to prevent or reduce the occurrence of a particular event or condition, in this case, stillbirth.
2. Stillbirth: Stillbirth refers to the death or loss of a baby before or during delivery. Both miscarriage and stillbirth describe pregnancy loss, but they differ according to when the loss occurs. In medical terms, a stillbirth is generally considered to occur when a fetus dies after 20 weeks of gestation.
3. Gravida Two Pregnancy: This term is used in the medical field to denote a woman who is pregnant for the second time. ‘Gravida’ refers to the number of times a woman has been pregnant, regardless of whether these pregnancies were carried to term. A gravida two pregnancy, therefore, means that the woman is on her second pregnancy.
4. Women: In this context, women refer to adult human females who are capable of bearing children or who have borne children. In the Azu Health Centre study, the term specifically refers to those who are on their second pregnancy.

Project – Control of still birth among gravida two pregnancy women in Azu Health Centre