Browsing by Subject "Midwifery"
Now showing 1 - 4 of 4
Results Per Page
Sort Options
Item Helping Mothers Survive: Implementing the Bleeding After Birth Program at the John F. Kennedy Medical Center in Monrovia, Liberia(2017-05-01) McDaniel, Paige E.While significant throughout Sub-Saharan Africa, the West African country of Liberia suffers from one of the highest maternal mortality rates in the world. Here, the lifetime risk of a woman dying as a result of pregnancy or childbirth complications is 1 in 24. Although pregnancy-related hypertension conditions, anemia, infection, and unsafe abortion all attribute significantly to maternal death, postpartum hemorrhage – heavy, life-threatening bleeding after childbirth – is the leading cause of maternal mortality globally. Research suggests that active management of the third stage of labor (AMTSL), a practice that shortens the length of time from the delivery of the baby to the delivery of the placenta through the use of medications and manual interventions on the part of the provider, can significantly reduce the incidence of postpartum hemorrhage where necessary resources are available and where health workers receive training in using AMTSL. The Helping Mothers Survive – Bleeding after Birth (HMS-BAB) program is a didactic and simulator-based training package for frontline maternity providers to equip them with the knowledge and skills needed to prevent mothers from dying on the day of birth. The program is centered on the evidence-based practice of AMTSL for hemorrhage prevention, as well as the necessary steps to engage should a postpartum hemorrhage occur. Recent research suggests the HMS-BAB program significantly improves a provider’s knowledge, skill, and confidence in managing postpartum hemorrhage, both initially as well as over time. The following describes the implementation process to bring the HMS-BAB Program to the John F Kennedy Medical Center in Monrovia, Liberia’s. This tertiary-care medical campus includes a 139-bed women and infant hospital and neonatal intensive care unit where Certified Midwives attend the vast majority of vaginal deliveries. The HMS-BAB program was introduced there in January, 2016, and successfully trained over 92% of the midwives working in the maternity hospital. While knowledge and skill gaps related to AMTSL practice were identified, midwives who completed the program reported improved self-efficacy and intent to incorporate AMTSL techniques into their practice. A clinical guideline was created and given to the administrators, nurses, and physicians of the maternity hospital to reinforce and sustain this change in practice.Item Including ultrasound scans in antenatal care in low-resource settings: Considering the complementarity of obstetric ultrasound screening and maternity waiting homes in strengthening referral systems in low-resource, rural settings(Elsevier, 2019) Swanson, David L.; Franklin, Holly L.; Swanson, Jonathan O.; Goldenberg, Robert L.; McClure, Elizabeth M.; Mirza, Waseem; Muyodi, David; Figueroa, Lester; Goldsmith, Nicole; Kanaiza, Nancy; Naqvi, Farnaz; Pineda, Irma Sayury; López-Gomez, Walter; Hamsumonde, Dorothy; Bolamba, Victor Lokomba; Newman, Jamie E.; Fogleman, Elizabeth V.; Saleem, Sarah; Esamai, Fabian; Bucher, Sherri; Liechty, Edward A.; Garces, Ana L.; Krebs, Nancy F.; Hambidge, K. Michael; Chomba, Elwyn; Bauserman, Melissa; Mwenechanya, Musaku; Carlo, Waldemar A.; Tshefu, Antoinette; Lokangaka, Adrien; Bose, Carl L.; Nathan, Robert O.; Pediatrics, School of MedicineRecent World Health Organization (WHO) antenatal care recommendations include an ultrasound scan as a part of routine antenatal care. The First Look Study, referenced in the WHO recommendation, subsequently shows that the routine use of ultrasound during antenatal care in rural, low-income settings did not improve maternal, fetal or neonatal mortality, nor did it increase women's use of antenatal care or the rate of hospital births. This article reviews the First Look Study, reconsidering the assumptions upon which it was built in light of these results, a supplemental descriptive study of interviews with patients and sonographers that participated in the First Look study intervention, and a review of the literature. Two themes surface from this review. The first is that focused emphasis on building the pregnancy risk screening skills of rural primary health care personnel may not lead to adaptations in referral hospital processes that could benefit the patient accordingly. The second is that agency to improve the quality of patient reception at referral hospitals may need to be manufactured for obstetric ultrasound screening, or remote pregnancy risk screening more generally, to have the desired impact. Stemming from the literature, this article goes on to examine the potential for complementarity between obstetric ultrasound screening and another approach encouraged by the WHO, the maternity waiting home. Each approach may address existing shortcomings in how the other is currently understood. This paper concludes by proposing a path toward developing and testing such a hybrid approach.Item Indiana State Board of Health. Monthly Bulletin, 1907 Vol. 9 No. 12(12/1/1907) Barnard, H. E.