RESPECTFUL MATERNITY CARE

The Miscarriage Support and Information Centre is part of the White Ribbon Alliance and our June Action of the month is focused on respectful maternity care.

In their power point presentation designed for healthcare workers, they make a very valid point, a point that I am particularly passionate about.

“The concept of ‘safe motherhood’ is usually restricted to physical safety, but safe motherhood is more than just the prevention of death and disability. It is respect for women’s basic human rights, including respect for women’s autonomy, dignity, feelings, choices, and preferences”.

When having to manage complications of pregnancy such as early or late miscarriage, healthcare workers are often driven by a need to do what they feel is best to prevent death and disability. However, in caring for a woman during such a traumatic time, it is important to work with her and not just “for her own good”. It is important that she understands what is going on and why. It is important, for example, to respect her wish to not undergo a surgical evacuation even though you may feel it is the best option.

In the survey I conducted in Lagos, Nigeria of the 25 women who had experienced a miscarriage, 21 remember being treated with sympathy and understanding by the hospital staff. However, only 14 women felt that medical professionals were not to blame for the pregnancy loss. Why the disparity?

I strongly believe that these 11 who did not excuse the healthcare workers involved in their care are the women who did not understand what was going on, were not consulted, had nothing explained to them and had no choice in how the miscarriage was handled. Hence, they believe something was not done right.

When asked, in the same survey, about attributes in their healthcare professionals that were very important, “includes you in the choice of treatment” was not ranked very high by these women respondents. However, “tells you all that is going on and why” was ranked very important with “explains in words you understand” ranked highest of all.

As 2015 draws closer and closer, it is very important that healthcare workers and policy makers recognise that when we go beyond preventing maternal deaths and work towards maternal healthcare that is respectful of women’s feelings, choices and dignity we will not only “improve maternal health” but we will also “promote gender equality and empower women”.

THE PERCEPTIVE PRACTITIONER

Clinical practice is constantly evolving and healthcare professionals are constantly finding themselves playing catch-up.

If you pride yourself on being the best you possibly can be, if you desire to deliver evidence-based and up-to-date clinical care, then you would have realised by now that there aren’t enough hours in the day to keep up with all you need to know and practice it as well.

Spontaneous miscarriage is the commonest medical complication of pregnancy and indeed the commonest medical complication in humans. Knowledge about all aspects of the management and healthcare of women after this event – physical, mental and social – is constantly evolving.

Empathy, by its very definition, requires the healthcare professional to be understanding and to be sensitive to the feelings and experiences of our patients, vicariously feeling what they feel without having actually felt it before. 

The questions that arise as a result include, "How do you empathise with a loss you have never felt before?" and "How do you provide holistic care when faced with a miscarriage?"

I hope, at least in this area of medicine, to be of great assistance to you. Evidence-based facts, news and advances in management, personal stories of miscarriage and pearls for practice will all be made available twice a month, every month.

I hope you will be able to find the time to read the posts. I hope you find this blog useful. I hope you tell others about it. I hope you will see the difference it will make to your practice.

Here’s to you: the perceptive practitioner.