Maternal perception of fetal movements: views, knowledge and practices
of women and health providers in a low-resource setting
Abstract
Objective To assess the perception, knowledge, and practices
regarding maternal perception of fetal movements (FMs) among women and
their healthcare providers in a low-resource setting. Design
Qualitative study. Setting The maternity unit of Mnazi Mmoja
Hospital, Zanzibar, Tanzania. Population Pregnant and
postpartum women, and health providers. Methods Semi-structured
interviews, questionnaires and focus group discussions were conducted
with 45 Zanzibar women (18 antenatal, 28 postpartum) and 28 health
providers. Main outcome measures Descriptive and thematic
analyses were conducted to systematically extract subthemes within four
main themes 1) knowledge/awareness, 2) behavior/practice, 3) barriers,
and 4) improvements. Results Within the main themes it was
found that 1) Women were instinctively aware of (ab)normal FM-patterns
and healthcare providers had adequate knowledge about FMs. 2) Women
often did not know how to monitor FMs or when to report concerns. There
was inadequate assessment and management of (ab)normal FMs. 3) Women did
not feel free to express concerns. Healthcare providers considered
FM-awareness among women as low and unreliable; lack of staff, time and
space for FM-education, and no protocol for FM-management. 4) Women and
health providers recognized the need for education on assessment and
management of (ab)normal FMs. Conclusion Women expressed FMs in
an adequate way and perceived abnormalities of these movements better
than assumed by health providers. There is a need for more evidence on
the effect of improving knowledge and awareness of FMs in order to
construct evidence-based guidelines for low resource settings.