Shadowing a DoctorAugust 1, 2014
Skilled attendance at birth is considered to be the single most crucial intervention for ensuring safe motherhood and childbirth. Complications can arise at any time during pregnancy and birth and when they do, having a skilled professional present during childbirth can mean the difference between life and death.
Skilled attendance does not just include midwives and others with midwifery skills. It also includes the conducive environment they need in order to be able to perform efficiently. This means easier access to equipment as well as a more comprehensive level of obstetric care in case complication arise that require blood transfusions or surgery.
Complications are unpredictable but they are mostly treatable
Up to 15% of all births are complicated by potentially fatal conditions and although many of these complications cannot be predicted, almost all can be treated.
Skilled attendants are trained to recognise the onset of problems, when the situation is more easily controllable and to intervene and manage the complication or stabilise the condition before referring the patient to a higher level of care if necessary. Skilled attendance is also critical for protecting the health of newborns. Statistics indicate that of all perinatal deaths, most occur during labour or delivery or if the baby is born, within the first 48 hours after delivery.
Yet in the developing world, only about 58% of all deliveries are attended by skilled health providers. In some countries, the figure is closer to 10-12%. And in many of those cases, there is no access to life-saving emergency care should something go wrong.
In order to save lives, skilled attendants need to have easier access to a larger health care system with the facilities, professionals, transport and supplies necessary to provide emergency obstetric care when it is needed.
Disparities in maternal care
Since it is difficult to determine which women may or may not develop life-threatening complications, every pregnant woman should ideally have access to a professional health provider for prenatal care and delivery care.
However, enormous disparities remain between countries and even within the same country. Women in developing countries are far less likely to receive the care they need during childbirth. This is because in many areas, hospitals and health clinics are often spread out over huge distances and transportation systems are often basic or non-existent. In addition, irrespective of their location, impoverished women do not have access to proper healthcare at any time.
To ensure that women around the world, irrespective of geographical location or financial status, receive much-needed care during their pregnancy and childbirth, global organisations such as the UNFPA advocate increasing the number of community-based midwives and strengthening district-level health systems to provide backup support. This opens up plenty of opportunities for midwives looking for the experience to get their career started off as well as for more experienced midwives looking for something that’s more challenging and immensely more satisfying than a routine job.