Sensitive Midwifery - Issue 44 - October 2019

Babies born by C-section deserve skin-to-skin care too Skin-to-skin care (SSC) during caesarean delivery is becoming increasingly popular in many countries because of numerous benefits. A recent study reported on perceived stumbling blocks to SSC implementation intraoperatively and in the recovery room. Lack of sta ff perseverance to promote non-disruption of the mother-baby dyad is a significant factor resulting in low rates of early SSC at caesarean births. While the possible risks of the neonate being smothered on the mother’s breast, sudden postnatal collapse due to airway obstruction and accidental falls are acknowledged, SSC is safe with vigilant health care. At St Mary’s Hospital in Durban, nurse-midwife Evashnee Naidoo has successfully taken the lead in implementing SSC at C-section births. She shared the protocols for this at Sensitive Midwifery Symposium in June 2019 and wrote about it in Issue 43 of Sensitive Midwifery Magazine . Elsaharty, A, et al. ‘Skin to skin: A modern approach to caesarean delivery’, Journal Obstetric Anaesthesia Crit Care, 2017, 7:13-9 Managing a midwifery group practice Despite well-known benefits of continuity of midwifery care, one Australian study shows that less than 10% of women have access to this model of care. Sta ff retention and satisfaction (important to achieve continuity of care) are strongly related to the quality of management. The study concluded that managers of midwifery group practices require certain attributes to e ff ectively manage these unique services, whilst also juggling the needs of the organisation as a whole. Having transformational leadership qualities with vision to lead the practice into the future are key. The study shows that there needs to be better support and preparation for this role if midwifery group practice is to be a sustainable option for women and midwives. Rest assured, Sensitive Midwifery won’t let this one slip o ff the agenda! Hewitt, L, et al, ‘Women and Birth. What attributes do Australian midwifery leaders identify as essential to e ff ectively manage a Midwifery Group Practice?’, Women and Birth , 2019, 32(2), 168–177 Peanut ball helps labour progress For women labouring with an epidural, a peanut-shaped exercise ball can decrease the length of labour and increase the chances of achieving vaginal birth, one randomised, controlled study has found. This nursing intervention not only resulted in significantly fewer C-sections, but the women who used it demonstrated shorter first stage labour (by 29 minutes) and second stage labour (by 11 minutes), compared to those who did not use the ball. Tussey, CM, et al, ‘Reducing Length of Labor and Cesarean Surgery Rate Using a Peanut Ball for Women Laboring With an Epidural’, The Journal of Perinatal Education , 2015, 24(1). Available: https://connect. springerpub.com/content/sgrjpe/24/1/16 C-sections riskier in some regions of the world A systematic review and meta-analysis published earlier this year has revealed that in certain low- and middle- income countries, a third of all babies delivered by C-section do not survive, and that women undergoing the procedure are 100 times more likely to die than those having a C-section in the UK. Torjesen, I, ‘Caesarean section is highly risky for mothers and babies in low and middle income Countries’, BMJ , 2019, 364. Available: https:// www.bmj.com/content/364/bmj.l1499 Birth review Birth 27 eSensitive Midwifery Magazine Issue 44