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.
Keywords Fetal Movements; Stillbirth; Low- and middle-income
countries; Low-resource settings
Tweetable abstract Women and health workers in Zanzibar
recognize the relevance of fetal movements, evidence on its integration
in care is needed