Official websites use. Share sensitive information only on official, secure websites. You do not have permission under this licence to share adapted material derived from this article or parts of it. High rates of labour augmentation with oxytocin have been found in some low- and lower-middle-income countries, causing potential perinatal harm.
It is critical to understand the reasons for this overuse. Aim was to explore factors that shape practices around using oxytocin for labour augmentation in a high-volume labour ward in Dar es Salaam, Tanzania. Mixed-methods data collection was conducted from March to February , including structured observations of births, h of unstructured labour ward observations and 13 individual in-depth interviews with birth attendants.
Thematic network analysis and descriptive statistics were used to analyse data. We used a time-lens to understand practices of oxytocin for labour augmentation in time-pressured labour wards. Birth attendants constantly had to prioritise certain care practices over others in response to time pressure. This led to overuse of oxytocin for augmentation to ensure faster labour progression and decongestion of the, often overburdened, ward. Simultaneously, birth attendants had little time to monitor foetal and maternal condition.
Surprisingly, while oxytocin was used in out of Liberal use of oxytocin for labour augmentation was facilitated by an underlying fear of prolonged labour and low alertness of oxytocin-related risks.
Time scarcity in the labour ward often made birth attendants deviate from clinical guidelines for labour augmentation with oxytocin. Efforts to navigate time pressure resulted in too many women with uncomplicated labour progression receiving oxytocin with little monitoring of labour. Fear of prolonged labour and low alertness to oxytocin-mediated risks were crucial drivers.
