ARTICLE OF THE MONTH Sudden infant death syndrome (SIDS): Our finest hour?
Founder of Every Birth a Safe Birth
Unexplained infant deaths have reached the lowest level on record in England and Wales 212 deaths in 2014, a rate of 0.3 deaths per 1,000 live births (Office for National Statistics [ONS] 2016). Here, I trace this remarkable public health success story, consider the current situation and ask what midwives might learn from the SIDS story to help tackle current public health challenges.
The fundamental skills: reducing maternal morbidity and mortality
Lecturer in Midwifery at University of Central Lancashire
The accurate assessment of basic observations such as blood pressure, heart rate, arterial oxygen saturation of blood (SpO2), respirations, temperature and level of consciousness (AVPU score) underpin the fundamentals of basic midwifery care provision. However, after identifying that the signs of impending maternal collapse often went unrecognised leading to subsequent morbidities and mortalities, the confidential enquiry into maternal and child health (CEMACH) report in 2007 (Lewis 2007) recommended that all obstetric women’s observations were recorded through a modified early obstetric warning system (MEOWS). This allows for the early detection of women who may become critically unwell and provides an opportunity for practitioners to act promptly and prevent deterioration (Knight et al 2016). This article provides an overview of the MEOWS scores as a tool to improve maternal morbidity and mortality within maternity care.
Rev Daniel Richards, Assistant Anglican Chaplain for the University of Salford
Child death before term affects many parents. This article is the story of one of those circumstances, but quite a rare one. Rev Daniel Richards talks of how his daughter Abigail grew to five months before it was discovered she had anencephaly. And, if you don't know what to say to a grieving parent, say nothing This article will discuss: Narrative of the situation: events and feelings. The excellent standard of care received by those present: despite difficult circumstances, the behaviour of the health professionals dealing with the situation was sensitive and compassionate The helpful/unhelpful things that are said and done – not simply by those working there, but that people everywhere need to know about how to approach situations with the sensitivity and care required. The holistic value of what it means to be empathetic. Basic encouragement to those seeking midwifery/healthcare that what they do is intrinsic to life and the gift of life.
The midwife’s role in caring for the needs of bereaved parents following a stillbirth
Lecturer in midwifery at the University of Salford(June 2016)
The unexpected loss of a baby can be both a devastating and traumatic experience for parents. Inadequate care and support can potentially lead to mental health problems such as complicated or traumatic grief. This article will review the midwife’s role in providing more effective meaningful and supportive care for bereaved parents following a stillbirth. It will also highlight the educational needs of student midwives to ensure they are equipped with the necessary knowledge and skills to support bereaved parents
Who listens to parents and is anything done?
Emeritus professor of midwifery at the University of Edinburgh(July 2014)
The 'Listening to parents' survey, which took place in early 2014, sought the views of parents bereaved by stillbirth or early neonatal death. The findings showed the marked variation in care provided. The low response rate may call into question the authority of the findings. Research into perinatal loss seems to be unlikely to be operationalised. More qualitative research may make such implementation more feasible, hopefully making optimal care more certain for grieving parents.
Safe motherhood initiative: what is next?
Clinical midwife tutor at Trinity College Dublin(June 2014)
When in 1987, the Safe motherhood initiative was launched, the aim was to reduce global maternal mortality by half by the year 2000. However this goal was not achieved and consequently the 5th Millennium Development Goal (MDG-5) was dedicated to maternal health which aimed at a three quarters reduction of maternal mortality by 2015. The international figures indicate that 287,000 women continue to die from complications relating to pregnancy and childbirth, mostly in poorly-resourced countries. As 2015 draws closer and with MDG-5 lagging behind, there is increased tension amongst those concerned about poor maternal health because of missed targets and a fear that it has slipped off policy agenda. The need to refocus discussion in this area becomes ever more vital. This article aims to do just that.