Sensitive Midwifery - Issue 44 - October 2019

If we are to be ‘with women’ as midwives, we must advocate for and adopt woman-centred care, says midwifery lecturer Sanele Lukhele. more woman-centred Let’s make maternity units W oman-centred care, the best model of care during the peripartum period, is an approach where a woman is kept at the centre of her birth experience. This means that the healthcare practitioner and the woman share in the decision- making regarding her care, with the understanding that childbirth is a natural physiological event. Woman-centred care is supported by national and international policies such as the Batho Pele principles, the Patients’ Rights Charter, the Better Births Initiative and the recent WHO recommendations: ‘Intrapartum care for a positive childbirth experience’. Sadly, this approach is not used in most public and private maternity settings in South Africa, where the biomedical model tends to influence doctors, nurses and midwives to view pregnancy and childbirth as high-risk conditions, even in a low-risk woman. This inevitably leads to rigorous monitoring of women during childbirth, and intervening at the earliest sign of supposed pathology. Achieving woman-centred care Transforming a maternity unit to being woman- centred depends heavily on buy-in from the midwives who work in that unit. A study done on perspectives of midwives regarding woman- centred care revealed that some midwives feel ill-equipped as they don’t have enough knowledge of what woman-centred care entails. Training on this model of care, as well as its benefits, could go a long way to making the practice a success within maternity units. Studies have shown that midwives have also cited lack of time and increased workload as barriers to woman-centred care, with inadequately sta ff ed maternity units having a direct impact on the implementation of this practice. For birthing units in low- and middle-income countries, the International Federation of Gynaecology and Obstetrics suggests the following sta ffi ng ratios: one midwife for eight patients in the latent phase, one midwife for two patients in the active phase of labour and two midwives for one patient in the second stage of labour. Read more about Sanele Lukhele on page 4 Birth Continued on page 29 28 eSensitive Midwifery Magazine Issue 44