Quiz 2: Mother friendly care during labour, delivery and the puerperium

Please choose the one, most correct answer to each question or statement.

1. Can a woman play an active part in her labour and delivery?
   • Yes. She should be encouraged to play an active role.
   • Only if she is multigravida and has experienced a vaginal delivery before.
   • Only if she has attended antenatal classes.
   • No. Most women do not have the knowledge or training to play an active role in their labour and delivery care.
2. Should women routinely receive an enema during labour?
   • Yes, as it speeds up the first stage of labour.
   • Yes, as it avoids the passage of stool with the delivery.
   • No, as it increases the risk of meconium stained liquor.
   • No, as there is no scientific evidence that it has any benefit.
3. What are the advantages of shaving women during labour?
   • It decreases the risk of infection if the perineum tears.
   • It decreases the risk of infection if an episiotomy is done.
   • It is part of good training and practice.
   • There are no advantages and routine shaving should be stopped.
4. Should women be allowed to shower or bath during labour?
   • No as it increases the risk of infection.
   • No as the fetus may drown before it is born.
   • Yes as it helps control the pain in labour.
   • Yes as it prevents dehydration during long labours.
5. Should women be allowed to drink during labour?
   • Only if they are in the second stage of labour.
   • Yes, as long as they are not being prepared for a Caesarean section under general anaesthetic.
   • They should only drink during early labour.
   • No, women should not drink at any stage of labour in case they may vomit during delivery.
6. Is it safe for a woman to eat during labour?
   • She can eat whatever she wants, even a large meal.
   • She can eat as much as she wants as long as she does not eat meat.
   • She can have small snacks.
   • Women in labour can drink but must not eat.
7. Is it safe to walk around during labour?
   • No. Women in labour should remain in bed.
   • They can walk to the toilet only.
   • They can walk around until they reach 5 cm cervical dilatation.
   • Most mothers may walk around during labour.
8. Do women need a labour companion?
   • Most women would benefit from a labour companion.
   • Only primiparous women need have a labour companion.
   • A labour companion is sometimes needed but this is impractical as they get in the way and interfere with the work of the midwives and doctors.
   • They are not needed as midwives can look after women in labour.
9. Is routine fetal heart rate monitoring needed in all labours?
   • Yes.
   • Only in high risk labour.
   • Only if the liquor is meconium stained.
   • No.
10. Should all women to offered pain relief in labour?
    • All women should routinely be given some pain relief in labour.
    • All women should be offered pain relief during labour.
    • Women should only be given pain relief if they ask for it.
    • Women should only be given pain relief if the doctor or midwife feels they need it.
11. Should routine early rupture of the membranes be encouraged?
    • Yes as it speeds up labour.
    • Only if the fetal head has not yet engaged.
    • Only in women who are HIV positive.
    • No as there are no proven advantages.
12. What is a ‘natural childbirth’?
    • A vaginal delivery.
    • A delivery with minimal medical interference so that the woman has as much control as possible over her delivery.
    • A delivery following the spontaneous onset of labour.
    • A delivery at home with the family present.
13. Is it better if a doctor delivers all infants?
    • Yes as they have had the most training.
    • Yes as this will lower the Caesarean section rate.
    • No as midwives can very competently deliver most infants.
    • No as doctors in many poor countries are only allowed to perform instrument deliveries and Caesarean sections.
14. Can women be safely delivered at home?
    • This is a dangerous practice and must be discouraged.
    • Home delivery is safe if the delivery is performed by a doctor.
    • Home delivery is safe if women are carefully selected and the home circumstances are adequate.
    • In most poor countries a home delivery is as safe as a hospital or clinic delivery.
15. In South Africa most women should be delivered:
    • At home.
    • In a primary care maternity centre.
    • In a general district hospital.
    • In a regional maternity hospital.
16. Who should conduct deliveries in developing countries?
    • Most families can safely conduct deliveries.
    • Only trained birth assistants should perform deliveries.
    • Untrained traditional birth attendants can safely deliver infants.
    • Only midwives and doctors should manage deliveries.
17. Should the father be present at delivery?
    • Yes, if possible.
    • Only if the labour ward is not busy and the couple are married.
    • Only if the mother has a normal vaginal delivery.
    • No, as fathers only cause trouble in a labour ward and often upset the woman and staff.
18. In what position should women deliver?
    • On their back or in the left lateral position as this is easiest for the midwife or doctor.
    • Only on their back as this is the safest position.
    • In whatever position is most comfortable for the woman.
    • If possible they should deliver underwater.
19. Episiotomies should be done:
    • In all primigravid women, especially if the perineum is tight.
    • In all women to prevent third degree perineal tearing.
    • Only be done if there is a medical indication.
    • Only if the woman is known to be HIV negative.
20. What is the Better Birth Initiative?
    • A national government project to deliver as many women in hospital as possible in order to lower the maternal and perinatal mortality rates.
    • An international project to improve labour and deliver care by listening to women’s views and practicing evidence based medicine.
    • A programme to train midwives.
    • A programme to train traditional birth attendants (TBAs).