Date of Award


Document Type



Edith Cowan University

Degree Name

Doctor of Philosophy


School of Nursing


Faculty of Computing, Health and Science

First Supervisor

Dr Yvonne Hauck

Second Supervisor

Dr Leanne Monterosso

Third Supervisor

Kieran McCaul


Childbirth education provided to women is an Integral aspect of the childbirth experience. In Malawi, midwives face a major challenge because one of their major roles is to provide childbirth information to women. However, there are no existing Childbirth Education Programs to facilitate this process. The purpose of this study was, therefore, threefold. First, it explored childbirth Information needs of Malawian mothers from the perspectives of both mothers and midwives, as well as strategies that would be appropriate to disseminate this childbirth information to Malawian women. Second, it developed a Childbirth Educational Program (CEP) to meet the specific needs of Malawian women as previously identified. Third, the CEP was implemented and evaluated for it’s effectiveness in increasing Malawian women’s knowledge of childbirth. The study was conducted in three phases. In Phase One, childbirth information needs of Malawian women were determined using findings from previous studies, focus groups and individual interviews of Malawian midwives. In Phase Two, data obtained from Phase One was used to develop a CEP as well as pretest/posttest questionnaire. In Phase Three, a quasi-experimental study using sequential sampling was conducted to implement and evaluate the CEP. Participants Included pregnant women who attended antenatal clinics at the Ndirande and Limbe Health Centres in Blantyre (Malawi). Following informed consent, 125 women from the Ndirande Health Centre were Invited to participate in the study and recruited to a control group. Another 125 women were also recruited to an intervention group at Limbe Health centre. A pretest was administered to both groups of women to determine their childbirth knowledge prior to implementation of the study. Women In the control group were exposed to routine antenatal education from both hospital and traditional non-hospital sources. Therefore, an increase in childbirth knowledge was anticipated. Additionally, women in the intervention group were exposed to both routine antenatal education as well as a systematic and comprehensive CEP. It was anticipated the degree to which knowledge increased in this group would be higher than in the control group, thus demonstrating the effectiveness of the CEP.