Factors influencing the competence of student midwives in symphysis-fundal height measurement: A quantitative study

Background: Given the central role of antenatal competencies in midwifery practice and the critical importance of accurate symphysis-fundal height (SFH) measurement for monitoring foetal growth, it is essential to explore the factors that influence student midwives’ competence and confidence in performing this key clinical skill. Evidence showed inconsistency in SFH measurement among the midwives. Objectives: This study aimed to investigate factors influencing student midwives’ competence and confidence in the measurement, plotting and interpretation of SFH in selected public health institutions in KwaZulu-Natal. Method: A quantitative, descriptive cross-sectional design was employed. A convenience sampling technique was used to select participants. Data were collected from 184 student midwives of 250 student midwives using a structured questionnaire, yielding a response rate of 73.6%. Results: The study identified several factors influencing competence and confidence in SFH measurement, plotting and interpretation, including regular communication (74.4%), constructive feedback from clinical lecturers (76.1%), student–preceptor relationships (64.9%), role modelling (78.2%) and the overall learning environment (69.2%). Conclusion: Although many students reported receiving constructive feedback and positive role modelling, variability across units underscored the need for a more structured and standardised approach to clinical teaching and mentorship. Strengthening the clinical learning environment is essential to complement existing teaching strategies and ensure consistent, high-quality preparation of midwives. Contribution: The findings will guide curriculum developers to consider SFH skills as stand-alone procedures, so students can practise them and become competent at the point of registration as a midwife.