Universal care that can save mums and babies
Women and babies are especially vulnerable around the time of birth. In cases of emergency such as haemorrhage, fits associated with high blood pressure, and babies who need help to breathe, time is of the essence. The speed with which appropriate care is delivered can make the difference between life and death.
Keeping mothers and babies alive — wherever they are in the world
I’m interested to find out how we can use skills and lessons learned in emergency obstetric and newborn care in our own NHS in the countries where Save the Children works. I haven’t practiced midwifery for almost a year and a half, but this week I attended my old hospital, Chelsea and Westminster, to observe and participate in their MOMS (Multidisciplinary Obstetric and Midwifery Simulation) course.
I really enjoyed it; it reminded me of the things I miss about being a midwife, the excitement and privilege of being present at birth. But it really brought home to me how the skills we use in emergencies here are so similar to those we use overseas.
On the first morning of the course we had lectures and presentations and in the afternoon we practised our skills on manikins. We resuscitated the plastic baby with bag and mask and chest compressions, we re-enacted the manoeuvres to help deliver a baby wedged in the pelvis by its shoulders and we ran through postpartum haemorrhage and eclampsia drills.
Hi-tech learning: from plastic babies to breathing manikins
The following day we discussed why team work and communication is so important and how we can use lessons from the aviation industry to aid our communication in emergencies. Then, to everyone’s amazement, we were taken to a fully equipped delivery/ post surgery room, with a maternal manikin that could talk, had a pulse and made respiratory movements. There was a remotely controlled newborn manikin that also made breathing movements, had a heart beat, cried and changed colour depending on its oxygen saturation. The room was equipped with a one-way mirror and video cameras. Emergency scenarios are played out in real time and videoed, to be watched by participants afterwards so teams can see how they really behave in an emergency and discuss how to improve.
It’s really good for me to be up-to-date again on emergency obstetric care but what can I take from this that we can use in our programmes?
Already our programmes work with ministries of health to deliver training using the simple manikins (not the talking ones), dolls and pelvises but I think we could look more at improving communication skills in emergencies and strengthening the multidisciplinary nature of our trainings. A team from the hospital recently went to Gimbe in Ethiopia with Maternity WorldWide and implemented an adapted version of the MOMS training there. Their report back showed that it went well and participants were keen and hungry for knowledge.
The care women and babies need is universal
The drugs and equipment available in developing countries aren’t as extensive as those we have in the UK, but the skills needed are exactly the same. The use of basic drugs is also the same — oxytocin and misoprostal to contract the uterus and stop bleeding, antibiotics to treat infection and magnesium sulphate to control eclamptic fits — these are in the policies of many developing countries and are available to a varying degree.
The care that women and babies need at birth to save lives is universal. I’m grateful that I was able to take part in this training and I hope in the future we can work more with the NHS, sharing lessons learned and skills, especially in emergency obstetric and newborn care.
Every year 1.3 million newborn babies in the world’s poorest countries die because mothers give birth alone, or without a midwife. Join our campaign for 3.5 million more healthworkers