The Medical Bulletin

Every year, more than 200 million women become pregnant. In the last 25 years, there has been a steady increase in the rate of cesarean births, from 5.5% in 1970 to approximately 25% in 1995. ¹ This increase has occurred due to changes in managing several factors, including malpresentation, fetal distress, prior cesarean section, and dystocia. Given this increase in the cesarean section rate, all medical personnel participating in the care of a laboring patient must have complete knowledge of the management of normal labor and delivery. ² This knowledge will help prevent the necessity for cesarean sections by optimizing the care of laboring patients. However, childbirth is not a joyous event but a time of pain, fear, suffering and even death. Because of difficulties associated with human birth, women often require assistance during delivery. Childbirth may be surrounded by traditions, many of which are beneficial, but others may be harmful. ³

During labor and delivery, the Nurse–Midwives should administer sensitive and appropriate care based on the client's and her family's particular needs. They require a two-fold effort to assess labor progress and use personal skills to assess the client and family's needs during this physically and emotionally stressful time. Care in normal birth aims to achieve a healthy mother and fetus with the least possible level of interventions compatible with safety. Human labor is surprisingly hazardous. Evolution should favor mothers who deliver without problems; yet, for those without access to good medical care, the lifetime risk of dying from labor maybe 10% or more. ⁴ Nurses can help the nation achieve these goals by closely monitoring women during labor and birth and by teaching women as much as possible about labor, so that they can use as little analgesia and anesthesia as possible.

The investigator tries to highlight the Nurse-Midwive's role in the delivery room toward using proper and healthy practices compatible with good knowledge throughout the stages of labor.

General Objective:

• The Study will be carried out to assess the knowledge and practice of staff nurses about Normal Labour.

Specific Objective:

• To assess the knowledge of nurses about Normal Labour.
• To assess the nurse's practice. Normal Labour
• To examine the nurse's knowledge about the management of Normal Labour.

MATERIAL AND METHODS

        The Study was conducted at RMCH, a 1000-bed tertiary-level teaching hospital in Rajshahi, Bangladesh. The Study was carried out from December 2020 to June 2021. The total number of nurses working in this hospital was 450. The Study was conducted in thirty-four wards under four selected units, including 1) the Gynae ward, 2) the Labour ward, 3) the medicine ward, and 4) the Surgery ward. A total of N=50 nurses who met the following inclusion criteria were recruited into this Study to overcome non-response subjects.

RESULT

Now we can find out in this Study that. At the level of knowledge regarding the questionnaire are, Complete midwifery training, yes 94%, No  6%, Know  WHO recommended visit for an antenatal checkup, a.1st at-14wks 10%, b.2ndat-28wks 82%, c.3rd at-35wks 6%, d.4th at-39wks 2%, know what is Gravida, a. Total no of conception 92%,  b.Total no of delivery 4%, c.A number of children 0%, d.Duration of delivery 4%, Know the labour is called normal. At the demographic table, there selected ages 25-34 years 28%, 35-44year 56%, 45+   8%.Gender male, 0%, female 100%. Marital status, single 12%, married 84%, widow 4%.religion Muslim, 64%,Hindu 28%, Christian 8%,buddist 0%.Academic qualification, S.S.C 34%, H.S.C 40%, B.A/B.Sc 26%, Master 0%.Professional qualification, Diploma in Nursing, Diploma in Midwifery 60%, B. Sc. in public Health2%, Mp. H / M. Sc. 14%. B. Sc. in Nursing From, College of Nursing 24%,  Length of service 1  –10, 40%. 11  – 20, 50%. 21 – 30, 8%.31_40,2%.

Table no 1 LDL-C, 158.3 ±22.6 mg/dl, 156.1 ±27.8&157.2 ±26.7 mg/dl, HDL-C, 37.5 ±2.70 mg/dl, 35.5 ±2.21&36.4 ±1.90 mg/dl, Triglyceride165.8 ±30.8 mg/dl, 162.6 ±28.2&166.8 ±35.7mg/dl, Non-HDL-C 180.6 ±31.2 mg/dl, 182.4 ±29.2 & 185.2 ±32.4 mg/dl,  , FBG, 142.5 ±25.7 mg/dl, 148.2 ±26.9 & 145.8 ±27. mg/dl4, HbA1c, %, 5.82 ±0.2, 5.62±0.4 & 5.65 ±0.3 respectively of patients of  the three groups. The difference in the values of all parameters in respect of three groups was not statistically significant (p>0.05)

Table 1: Demographic information of the participated Nurse

Fig 1: Age of the respondents

Fig 2: Professional qualification of the respondents.

Table 02: Knowledge for Nurse about Normal Labour

Fig 4: Did you complete your midwifery training?

Fig 5: Do you know which one is WHO recommended visit for an antenatal checkup?

Table 3: Demographic information of the participated patient

Fig 6: Do the amount of time nurses spent with you?                        Fig 7: Do the nurse conduct delivered?

DISCUSSION

This Study investigated the knowledge of nurses and practice regarding Normal Labour. Nurses are the main healthcare providers in the hospital. They provide basic health care services and preventive care and educate communities. The Study found that nurses have influential positions in affecting patients' health decisions and health knowledge. However, there is controversial knowledge among nurses regarding the management of Normal Labour that impacts their service provision. 5

Regarding training courses in midwifery, the highest percentage (69.4%) of them have the opportunity to be enrolled or participated in training courses ranging between (1-5) courses, with a duration ranging from one week to more than one month. At the same time, one-third do not have training courses.

It was found that in-service training is essential to ascertain that midwives' skills and understanding of the quality of care have been updated to maintain high quality in their nursing and midwifery practices and give them the opportunity for high-quality performance. 6 The results presented a high mean of scores in nurse-midwives' knowledge regarding the second stage of labor in all items, such as definition, signs and symptoms, episiotomy and its benefits, conduction of delivery, and cord clamping and cutting. It was stated that nurses' knowledge is vital at all levels of nursing practice. 7 Knowledge and their impact on interactions with women's health care in the delivery room are essential to prevent labor complications. Labor support is important to this experience since it influences women's classification of the birth experience as positive or negative. By understanding professional labor support, intrapartum nursing knowledge can be advanced and help professional labor support interventions, enhancing the delivery process for all women. 8

Related practice, amount of time nurses spent with, 80% yes and 20% no. they always being a nurse around if you needed one,80% yes and 20% no. Nurse conduct delivered, 88% yes and 12% negative how nurses listened to your worries and Concerns, 88% yes and 12%no. The nurse told the mother about immunization, 84% yes and 16% no. the amount of information nurses gave you About your condition and treatmen,80% yes and 20%no. 92% yes and 8% no will be nurses' manner. The way nurses explained to you about beardown effort during 2nd stage, 88% yes and 12% no. After delivery, the nurse gives you uterine massage, 86% yes and 14% no.

1. CONCLUSION

In this study, decision-making for care was based on an evolving knowledge base, values and beliefs, and several contextual features. The theory explains why practice variation in stages of care exists among midwives and why changes to care to occur over time. It also explains why an individual midwife's practice changes in certain situations, according to the needs of the individual being cared for, changing midwife values and beliefs or environmental factors while still providing an explanatory framework for those who maintain established practices. Midwifery nurses play an important role in ensuring quality care during normal deliveries. They assist women in labor, monitor labor progress, and provide support and education to women and their families. In Bangladesh, midwifery care is becoming increasingly recognized as a crucial component of maternal and newborn health. The role of midwifery nurses in improving maternal and newborn outcomes, particularly in rural and underserved areas, is likely a key area of focus in studies on the quality of midwifery care in Bangladesh.

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