Midwifery: A rewarding profession


Sunday, June 10, 2018

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DESPITE the fact that midwives have been around for centuries, for some individuals, they remain an unheralded group of professionals.

However, midwife at the Darliston Health Centre in Westmoreland, Sateree Howell, says the profession continues to grow and, with it, the significant demand for its members' services.

She tells JIS News that midwives are specialist nurses who manage the reproductive health of women, particularly expectant mothers, from the time they conceive until they deliver.

Additionally, Howell says midwives promote contraceptive services, perform basic cancer screenings such as pap smears and breast examinations, pointing out that “we are trained to recognise any deviation from the norm and manage them accordingly”.

Midwives are often the ones on the front line administering the delivery of medical care to expectant mothers, and the Ministry of Health, through the Programme for the Reduction of Maternal and Child Mortality (PROMAC), has been doing its part to ensure that they (midwives) are well equipped to do their jobs.

Globally, an estimated 358,000 women succumb to pregnancy-related issues annually, with 90 per cent of these occurrences taking place in developing countries.

Data also shows that 75 per cent of these deaths occur during childbirth or in the post partum period.

However, Health Minister Dr Christopher Tufton notes that when women have access to quality reproductive health care, including skilled attendance at birth, the majority of maternal deaths are avoidable.

In 2013, the Government of Jamaica and European Union (EU) signed a $3-billion (22 million Euros) agreement to support the development of PROMAC, which aims to reduce child mortality and improve maternal health.

This programme, according to Dr Tufton, “is important because it focuses on a very critical aspect of public health… not just one that challenges us here in Jamaica in our own public health framework, but [also] globally, [as] every one to two minutes there is at least one death somewhere in the world related to some maternal issues”.

The project has seen well-needed improvements to hospitals and health centres through high dependency units.

Additionally, it addresses capacity and knowledge gaps in the health sector through the training of health professionals, research and institutional strengthening.

Another very important feature of PROMAC is its interventions at the community level to improve health care delivery.

Recently, 150 fully equipped midwifery bags were presented to the island's regional health authorities.

These provisions are among recent achievements for PROMAC, which is designed to improve the management of high-risk pregnancies at both the tertiary and primary care levels of the public health system, and promote and influence a positive approach by individuals to maternal and child health.

PROMAC's other notable achievements include: The deployment of six ambulances to six primary health care centres — the Mandeville, St Jago, Annotto Bay, and Savanna-la-Mar health centres — as well as the Chapelton and Alexandria community hospitals.

These facilities are also slated to receive radiographic and ultrasound equipment soon.

Deputy director general of the Planning Institute of Jamaica Barbara Scott, who spoke at the handover ceremony for the midwifery bags, noted that these inputs are intended to assist in providing care outside of the formal health care setting so that expectant mothers whose pregnancies are regarded as high risk will be able to receive check-ups closer to home.

According to Dr Tufton, the donation marks an “important step” in Jamaica's drive to improve health outcomes for the nation's mothers and children. This, he says, by ensuring that women have access to skilled and resourced attendance at birth.

This underscores the importance of midwives and the role they play throughout the health sector.

Nurse Howell points out that there are two categories of midwives — the community midwife and hospital midwife.

She explains that community midwives are trained to operate in primary health care, are assigned to clinics and do home deliveries.

She says their core functions at health centres entail providing preventative obstetrics care, while adding that hospital midwives primarily work at tertiary health facilities where they carry out the delivery of babies.

There is, however, a shortage of midwives, which the authorities have been working to rectify.

The ministry, in this regard, offers a free two-year certification training programme for individuals up to 40 years old who may be interested in entering the profession.

The programme is offered through training facilities at the Spanish Town Hospital and Victoria Jubilee Hospital, in addition to the Kingston School of Nursing and Midwifery, and Cornwall Regional School of Nursing and Midwifery.

Interested individuals over 40 years old are required to complete a mature entrance examination.

Despite the shortage, however, Nurse Howell says the county of Cornwall continues to outshine the others in terms of its low maternal mortality rate.

This, she says, is something the group of 54 midwives who operate in the western region hope to maintain, as they continue to promote and work towards achieving a reduction in child mortality and improving maternal health care, which were two of the targets under the United Nations Millennium Development Goals.

For Howell, being a midwife is a very fulfilling job that entails much more than delivering babies.

“Persons who are trained as midwives can operate birth units, can work with a private practitioner who has his/her own birthing unit, or she can set up her own birthing practice because you are registered and licensed,” she outlines.

Howell describes the engagement as the “complete package” in dealing with expectant mothers from the time they conceive.

“You [get to] know the baby [and] the [mother as] you are there with them [for an extended period]. She comes to the antenatal clinic, she delivers [and] you are seeing her for the rest of her time [spent in the health centre]. So it's [fulfilling as] a career if you are a people person,” she says.




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