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Article History

Received: 20 September 2025

Accepted: 30 December 2025

First Online: 21 January 2026

Declarations

:

: The Uganda National Council for Science and Technology (UNCST) granted ethical approval (UNCST) HS5048ES, while Bishop Stuart University in South Western Uganda served as the supervising institution (BSU-REC-2024–325). The University of Port Harcourt Research Ethics Committee in Nigeria also provided ethical approval (UPH/CEREMAD/REC/MM94/045). This study adhered to the Declaration of Helsinki's principles and regulations by protecting participants' rights and maintaining ethical standards to ensure their safety and maintain their health [ ].Written informed consent was obtained from the midwives as they reported on duty before observation. Mothers’ written informed consent was obtained by the trained research assistant on admission before active labour. Participants were guaranteed the highest level of confidentiality regarding the handling of acquired data. In order to honor the respondents' desires, mothers and midwives were free to leave the study at any point during the study. A counselor was recruited at each selected facility to counsel mothers that appeared emotionally distressed. Every technique was used in compliance with the applicable rules and regulations. For reasons of confidentiality, the study's results were kept on a password-protected computer.

: Not applicable.

: The authors declare no competing interests.