News
As we celebrate International Day of the Midwife and International Nurses’ Day in May, Monyebodi Hendrica Ngoepe, Nursing Executive for Mediclinic Southern Africa, provides some insights into the value these midwifery nurses offer our community and the importance of growing these skills.
According to the United Nations Sexual and Reproductive Health Agency, (UNFPA), while the number of midwives in Southern and East Africa has increased by 8% since 2017, the current number of midwives (2.5 midwives per 10,000 population) is still below the global average. According to this report, “The vast majority of maternal and newborn deaths are preventable with access to a workforce with expertise in sexual and reproductive health, most commonly found in a midwife trained to global standards.”
Within the South African context, midwives specialise in managing pregnancies and childbirth, and Monyebodi Ngoepe believes midwives are essential healthcare professionals within the care spectrum.
They deliver comprehensive care and enhance the health and wellbeing of mothers and newborns. “Our obstetric units are doctor-led, while midwives are crucial in providing comprehensive care and monitoring low-risk and high-risk patients. They work collaboratively with obstetricians to ensure the best possible outcomes for mothers and their infants, providing continuous support throughout the stages of labour, assisting with pain management, and guiding women through the birthing experience.” After childbirth, they care for both mother and infant, conducting postpartum and newborn assessments and providing breastfeeding support. In addition to delivering clinical care, midwives impart vital health education on infant care and breastfeeding, significantly enhancing the positive pregnancy and childbirth experience.
Collaboration and a personalised approach to the patient journey
“Within Mediclinic hospitals, midwives and doctors work closely together to prioritise the health of both the mother and the baby. Open communication is essential; because midwives have such hands-on care, doctors rely on them for insights into the progression of labour and the mother's condition, which help the doctor determine whether medical procedures, such as cesarean sections, are necessary,” she explains.
This is enhanced through participation in training and obstetrics drills, engagement in joint care planning and decision-making, and fostering a supportive work environment that cultivates a culture of teamwork. Mother and Baby Collaboration meetings, involving both nurses and doctors, provide opportunities for discussion of patient care and case studies, assuring patient-centred care.
“Mediclinic has identified key areas that allow us to provide a relaxed pregnancy journey to improve each patient's care pathways. Ante-natal classes to prepare parents for the birth are offered, including educating them on non-pharmacological and pharmacological pain management in labour,” she explains. The extended family is encouraged to visit and participate in creating a family unit. As a vital part of parent-baby bonding, Mediclinic promotes kangaroo care of the baby by parents, as well as ‘rooming in’ and breastfeeding. These approaches promote bonding between the baby and the family unit well before the new family is discharged. Replace it with before the mother and newborn are discharged.
“Although we follow evidence-based guidelines when caring for women and babies during the peri-natal period, we treat the family holistically and involve them in decision-making, from admission to discharge,” Ngoepe explains.
Focus on training
Continuous professional development is vital in specialised training for midwives, with new knowledge and updated skills available to improve the care being delivered. For this reason, several training initiatives have been implemented by Mediclinic to ensure that midwives are equipped to deliver safe care and enabled to manage complex cases. These initiatives include annual training needs analysis, two-yearly certification in basic life support, neonatal cardiopulmonary resuscitation, cardiotocogram, and partogram training and continuous professional development courses on various elements of patient care. Essential Skills in the Management of Obstetric Emergencies drills are practiced, ensuring nurses are well-equipped to deal with complications. Other opportunities include access to attend conferences to enrich their knowledge.
Ngoepe believes that mentorship is a vital strategy for enhancing the skills and confidence of midwives, particularly those less experienced. “We have a mentorship programme and structured unit-specific onboarding programmes where we pair experienced midwives – trained as mentors - with new or less experienced nurses. This mentorship fosters a supportive environment that promotes professional growth and improves patient care.”
Ngoepe highlights the collaboration between public and private sectors to advance skills, “Although the Mediclinic Higher Education Institution is accredited to offer the Advanced Diploma in Midwifery programme, our students are placed in the public clinical facilities to ensure they obtain the opportunity to do deliveries as, in the private sector, doctors mostly deliver babies. Most of their other clinical training is done in our accredited hospitals. We hope that in future, public midwifery students might be placed in our hospitals to experience ante- and post-natal care provision.”
In conclusion
“Promoting respectful care is essential. Pregnancy and birth are natural processes, and midwives are the custodians of respectful care. This means that every woman has a different background and needs. Our biggest role is to be the woman’s advocate. Allowing her to participate in her care, empowering her with knowledge and evidence-based practice, and making informed decisions.”