A study was conducted to describe midwives’ adherence to preoperative care during emergency
caesarian section at Bwaila Maternity Wing in 2012 in Malawi. The study utilized a descriptive
prospective and retrospective design. A structured questionnaire was administered to all 28 midwives
who were directly involved in the preparation of clients for emergency caesarean section.
Clients charts were also reviewed using a standard checklist to determine adherence to preoperative
care. Data were analyzed using SPSS version 16.0 and descriptive statistics in the form of frequencies
and percentages were computed for the dataset. A midwife was supposed to score at
least 80% on each component of preoperative care guidelines to be compliant to the stipulated
pre-operation standards. The midwives scored above 80% on only four of the 14 preoperative
care guidelines which were; bladder catheterization (100%, n = 14), obtaining informed consent
(92.9%, n = 12), administration of IV (96.4%, n = 13) and administration of preoperative antibiotics
(82.1%, n = 11). Midwives however scored less than 80% on preoperative procedures that
dealt with vital signs (28.6%, n = 4): BP check (28.6%, n = 4); Pulse rate check (25%, n = 3.5); respiration
check (25%, n = 3.5) and temperature check (25%, n = 3.5). The midwives scored further
below standard on blood specimen collection (78.6%, n = 11). Psychological support to clients was
also below standard at 60.7%, n = 8. Other components of psychological support such as surgery
information (57.1%, n = 8), allowing clients ask questions (28.6%, n = 4) and answering clients’
questions (25%, n = 3.5) were also scored below standard. Overall the standard of preoperative
care was below standard at the facility. Most of the midwives were new graduates, who had never
received any in-service training on preoperative care. Therefore in service training it is recommended
for the midwives to provide good quality of care.