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Abla El Kouche
Al Jowhara Hospital Mediclinc, UAE
Keynote: Gen surg: Open Access
Throughout the word midwifery has been practiced for centuries and has features and characteristics that have evolved differently according to local or regional culture and social traditions and knowledge. Definition of the midwife The internationally agreed definition recognises the midwife as responsible and accountable professional who works in partnership with women to: a. Give the necessary support, care and advise during pregnancy, labour and the postpartum period b. Conduct birth on the midwife’s own responsibility c. Provide care for the new born and infant, including preventive measures, the promotion of normal birth, the detection of complications in mother and child, the accessing of medical care. Midwifery care if uniquely nurturing, hands on care before, during and after birth. Midwives are health care professionals specializing in pregnancy and childbirth who develop a trusting relationship with their clients, which result in confident, supported labour and birth. While there are different types if midwives practicing in various setting, all midwives are trained to provide comprehensive pre-natal care and education, guide labour and birth, address complications and care for the new born. Across the planet, 80 % of people alive today have been born with midwives. Midwives attend approximately 70 % of all births. The countries with the lowest mortality and morbidity rates for mothers and infants are those in which midwifery is a valued and integral pillar of the maternity care system. The midwife has an important task in health counselling and education, not only for the women, but also within the family and the community. A midwife may practise in any setting including the home, community, hospitals, clinics or health units. 2. The midwives model of care is based on the fact that pregnancy and birth are normal events. The midwifery model is a low tech, high caring model that produces excellent outcomes not only for low risk client but for vulnerable and at risk people as well. Delivering high quality maternity care is the responsibility of every midwife. We all need to be activist, determined to take both small and big steps to directly or indirectly improve care. We midwifes deliver generally excellent services but there is more to do to achieve safe, high quality, individualised care for every woman every time. Diversity is welcome, but unacceptable varieties in standards and outcomes is not. The impact if major health service reforms, financial constraints and demands for greater efficiency, whilst al the same time improving quality safety and women’s experience, is felt in every maternity unit. So we all need to be clear about our vision of midwifery and what needs to happen to achieve it. Our challenge is to determine how best we can provide high quality care now and in the future, what service model and structure should we use, what should our workforce look like, how will midwives be trained and developed and how can our workplaces creates cultures where high quality is achieved or other appropriate assistance and the carrying out of emergency measures. High quality care should be safe, effective, women-centered, timely and equitable. The midwife thus has a vital part to play not only in helping to ensure the health of mother and baby, but in their future health and well-being and that of society as whole. The cores values include respect, compassion commitment to quality of care and working together for patients. Midwives are crucial members of the public health workforce, midwives know how to make public health interventions and many public health initiative require their input, Staff health and well-being is essential. Midwives must be healthy, well and at work. Promoting their health and well-being contributes directly to high quality care. It is essential that: • Staff feel safe, supported, respected and valued • That there is investment in training and development • Action to improve diversity, to eliminate bullying, to reduce workplace accident, to provide better occupational health services. The drivers of high quality care include workplace cultures that facilitate good team work, innovation time to care and staff raising concerns. The more positive the staff experience, the better outcomes for the employer. To conclude: Executive board, who has designated 2020/2021 as the “Year of the Nurse and Midwife” in honour of the 200th anniversary of the birth of Florence Nightingale and in the recognition of her contribution to health and humanity. With the right values, the right education and the right leadership, midwives can turn around outdated service models and practice. While most maternity care is safe and good quality, it could get even better. Changing times demand new solutions. We need a strong public health approach, community based care for all, continuity of care instead of fragmentation and respect for the central contribution of midwifery to high quality maternity services.
Alfonso Di Costanzo graduated in medicine and surgery (110/110 cum laude) in 1982 and was board certified in neurology (50/50 cum laude) in 1986. Presently, he is associate professor of neurology at the department of medicine and health sciences “Vincenzo Tiberio”, University of Molise, and is the director of Centre for Research and Training in Medicine of Aging, at the same university. His main research interests include prevention, diagnosis and treatment of neurodegenerative diseases and other aging-related diseases.
