Those of you who have been here awhile will remember how hard Shalena worked to bring midwifery to DR. Looks like it might finally begin.
Computer translated:
Health proposes to delegate labor in nurses
María Teresa Morel | August 23, 2017
Authorities suggest that midwives trained in obstetrics should follow labor to try to reduce the high rate of cesareans in the country
Faced with the growing number of cesarean sections performed in clinics and hospitals in the country, the Ministry of Health proposes a package of interventions, including the training and training of a specialized human resource to follow up on the twelve or sixteen hours involved in work of childbirth, with the professionalism, friendliness, respect and empathy demanded by women in that special moment of their lives.
According to the person in charge of the Department of Family Health of the Ministry of Health, José Mordán, this is a nurse with a degree in obstetric care, as it is in countries such as France, England, the United States, Chile, Costa Rica, Argentina, Uruguay and Puerto Rico.
"It has already been demonstrated with scientific evidence that this period that involves the onset of labor until the time of the expulsion is complete can be perfectly followed by a nurse previously trained for these purposes. In other developed countries it is not only a nurse, but an obstetrician who is a professional with a degree in obstetrics, explains Mordan during an interview with the Caribbean.
She says that when her colleagues at the highest level of the scale, such as obstetricians, analyze what the care of a physiological birth involves, the biggest obstacle is the time they must dedicate to labor, which is why they end up opting for a cesarean section.
With this proposal the doctor would be freed from this task and would only intervene in the event of a complication that would prevent the woman from continuing the course of the physiological birth.
To this end, the Ministry plans to work together with universities to create the curriculum for the training of these personnel, which would fill a fundamental space in the obstetric care process and significantly reduce the rate of cesarean sections that at the public level averages 42% And at private level 86%, according to official data.
Good practices
Another intervention is aimed at strict adherence to the guidelines and protocols, including the normal national birth protocol, which orders medical and nursing staff to use a control instrument called a partograph.
It is a form that is filled to the parturients in which are registered all the events of the course and evolution of the normal birth that allow to establish the interventions that would have to be adopted before arriving at an extreme resource like the Caesarean section.
According to Dr. Mordan, there is evidence that the use of partograph reduces the rate of cesarean section.
It indicates that the institution has sponsored training and dissemination of the protocols throughout the service network, including midwifery health providers at the public and private levels.
He added that other elements that would avoid cesarean section have to do with assisted delivery, which consists of the use of devices such as the forceps and the suction cup, which according to Mordan can be used effectively and safely to facilitate the baby's exit if there were An obstruction of labor.
The Ministry has also put the eye on the qualification and regulation of diagnostic services, to ensure the quality and competence of the personnel who performs the sonographies, because according to the official, the use of this technological resource can also induce the physician to perform cesarean sections Even in the absence of clinical evidence.
Safety of surgeries
According to the director of the Department of Family Health, the Ministry responsible for the rectory in health with the duty to ensure the safety of clinical processes, also ensures that the safety checklist The World Health Organization (WHO), which clearly establishes the steps to be followed by medical and nursing personnel before, during and after a surgical procedure such as caesarean section.
The Galician explains that in this exercise of vigilance seeks to identify the set of institutions that transcend the limits established as standards of good practices that assume that the rate of cesarean section does not exceed 20%.
Another indicator that seeks to attack is the rate of infection associated with health care that often occurs as a result of the practice of cesarean section.
To this end, the Baby Friendly Hospital strategy is promoted, which includes fundamental practices for the care of labor with minimal manipulation, the use of partograph, clean birth to avoid postpartum infections and postpartum haemorrhages.
Education in the Prep is Key
Education for women and the family is another key factor that needs to be addressed and that must start from prenatal checkups.
Mordán says that this is the ideal space to educate and psychologically prepare the woman and her family for childbirth, as well as the role they must play during the event. It also serves to prevent anemia, nutritional disorders, and preeclampsia or hypertension associated with pregnancy that place the woman on the cesarean line.
"We have to work and we work with divulging and informing the population especially the women and families of the benefits of natural childbirth, overcoming the stereotype of advertising, or the paradigm that says that the easiest way is cesarean delivery.
When safety and efficacy evaluations are done for everything that has to do with the incorporation of women into everyday life, which involves the care of the newborn, cesarean delivery is a serious limitation, "he says.
"Caesarean section is a barrier for women"
The official said that cesarean surgery is a major surgery that involves hospital complexity, highly qualified care, exposure to drugs and depressive drugs, including anesthetics; Which implies post operative pain that leads to the need to use pain medication and risk of infection.
"Finally, the practice of cesarean section is an element that constitutes a real obstacle for the reincorporation of women to work that together with the family should develop for the care of the newborn and of course to their productive life."
82%
Cesarean Nine out of ten women who give birth in private clinics do so through caesarean section.
15%
Standard The World Health Organization (WHO) recommends that the cesarean section rate should not exceed 15%.
http://www.elcaribe.com.do/2017/08/23/salud-propone-delegar-labor-parto-enfermeras/
Computer translated:
Health proposes to delegate labor in nurses
María Teresa Morel | August 23, 2017
Authorities suggest that midwives trained in obstetrics should follow labor to try to reduce the high rate of cesareans in the country
Faced with the growing number of cesarean sections performed in clinics and hospitals in the country, the Ministry of Health proposes a package of interventions, including the training and training of a specialized human resource to follow up on the twelve or sixteen hours involved in work of childbirth, with the professionalism, friendliness, respect and empathy demanded by women in that special moment of their lives.
According to the person in charge of the Department of Family Health of the Ministry of Health, José Mordán, this is a nurse with a degree in obstetric care, as it is in countries such as France, England, the United States, Chile, Costa Rica, Argentina, Uruguay and Puerto Rico.
"It has already been demonstrated with scientific evidence that this period that involves the onset of labor until the time of the expulsion is complete can be perfectly followed by a nurse previously trained for these purposes. In other developed countries it is not only a nurse, but an obstetrician who is a professional with a degree in obstetrics, explains Mordan during an interview with the Caribbean.
She says that when her colleagues at the highest level of the scale, such as obstetricians, analyze what the care of a physiological birth involves, the biggest obstacle is the time they must dedicate to labor, which is why they end up opting for a cesarean section.
With this proposal the doctor would be freed from this task and would only intervene in the event of a complication that would prevent the woman from continuing the course of the physiological birth.
To this end, the Ministry plans to work together with universities to create the curriculum for the training of these personnel, which would fill a fundamental space in the obstetric care process and significantly reduce the rate of cesarean sections that at the public level averages 42% And at private level 86%, according to official data.
Good practices
Another intervention is aimed at strict adherence to the guidelines and protocols, including the normal national birth protocol, which orders medical and nursing staff to use a control instrument called a partograph.
It is a form that is filled to the parturients in which are registered all the events of the course and evolution of the normal birth that allow to establish the interventions that would have to be adopted before arriving at an extreme resource like the Caesarean section.
According to Dr. Mordan, there is evidence that the use of partograph reduces the rate of cesarean section.
It indicates that the institution has sponsored training and dissemination of the protocols throughout the service network, including midwifery health providers at the public and private levels.
He added that other elements that would avoid cesarean section have to do with assisted delivery, which consists of the use of devices such as the forceps and the suction cup, which according to Mordan can be used effectively and safely to facilitate the baby's exit if there were An obstruction of labor.
The Ministry has also put the eye on the qualification and regulation of diagnostic services, to ensure the quality and competence of the personnel who performs the sonographies, because according to the official, the use of this technological resource can also induce the physician to perform cesarean sections Even in the absence of clinical evidence.
Safety of surgeries
According to the director of the Department of Family Health, the Ministry responsible for the rectory in health with the duty to ensure the safety of clinical processes, also ensures that the safety checklist The World Health Organization (WHO), which clearly establishes the steps to be followed by medical and nursing personnel before, during and after a surgical procedure such as caesarean section.
The Galician explains that in this exercise of vigilance seeks to identify the set of institutions that transcend the limits established as standards of good practices that assume that the rate of cesarean section does not exceed 20%.
Another indicator that seeks to attack is the rate of infection associated with health care that often occurs as a result of the practice of cesarean section.
To this end, the Baby Friendly Hospital strategy is promoted, which includes fundamental practices for the care of labor with minimal manipulation, the use of partograph, clean birth to avoid postpartum infections and postpartum haemorrhages.
Education in the Prep is Key
Education for women and the family is another key factor that needs to be addressed and that must start from prenatal checkups.
Mordán says that this is the ideal space to educate and psychologically prepare the woman and her family for childbirth, as well as the role they must play during the event. It also serves to prevent anemia, nutritional disorders, and preeclampsia or hypertension associated with pregnancy that place the woman on the cesarean line.
"We have to work and we work with divulging and informing the population especially the women and families of the benefits of natural childbirth, overcoming the stereotype of advertising, or the paradigm that says that the easiest way is cesarean delivery.
When safety and efficacy evaluations are done for everything that has to do with the incorporation of women into everyday life, which involves the care of the newborn, cesarean delivery is a serious limitation, "he says.
"Caesarean section is a barrier for women"
The official said that cesarean surgery is a major surgery that involves hospital complexity, highly qualified care, exposure to drugs and depressive drugs, including anesthetics; Which implies post operative pain that leads to the need to use pain medication and risk of infection.
"Finally, the practice of cesarean section is an element that constitutes a real obstacle for the reincorporation of women to work that together with the family should develop for the care of the newborn and of course to their productive life."
82%
Cesarean Nine out of ten women who give birth in private clinics do so through caesarean section.
15%
Standard The World Health Organization (WHO) recommends that the cesarean section rate should not exceed 15%.
http://www.elcaribe.com.do/2017/08/23/salud-propone-delegar-labor-parto-enfermeras/