Nepalese women suffering from uterine prolapse - A participant observational study in a maternity hospital in Nepal

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Author: Ingrid Broms; Anna-klara Ingvarsson; [2012-06-29]

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Abstract: Background:Uterine prolapse is a condition in which the muscles and supporting ligaments holdingthe uterus in place gets too weak to keep the uterus in position. This causes the uterus todrop into the vaginal canal and results in a downward malposition of the uterus. Riskfactors for uterine prolapse are among others pregnancy and delivery, improper deliverytechniques, heavy work during and soon after pregnancy and heavy lifting. In Nepaluterine prolapse is one of the main causes for ill-health among women of reproductiveand post-menopausal age. According to the United Nations Population Fund (UNFPA),the high number of affected women in Nepal is due to, among other reasons, the lack ofskilled birth-attendants, women carrying heavy loads, lack of contraceptives and givingbirth to many children.Aim:The aim of our study was to gain knowledge of how patients with uterine prolapse arecared for in a maternity hospital in Nepal.Method:An ethnographic approach was used to meet the aim of our study. Data was collected byfour weeks of participant observations in a hospital in Kathmandu. The observationswere complemented by interviews with patients and staff.Findings:The most striking part found in our material was the limited resources and their impacton the care provided to patients with uterine prolapse. The quality of the care wascompromised by the lack of good facilities, material resources and manpower. Thiscreated a frustration among the staff as well as an unnecessary suffering for the patients.We identified three main categories in the data collected; Prerequisites for caregiving,Consequences for the patients and Consequences for the caregivers. These themes arepresented in sixteen subheadings lifting different aspects of how the lack of resourcesaffected the care.

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