Every year, more than 529.000 women and more than 5,7 million babies die before, during, or after childbirth, the majority in developing countries. The International Confederation of Midwives (ICM) and the World Health Organization (WHO) are determined to respond to these tragedies and have developed six Midwifery Education Modules to complement clinical tools and tools for management, planning and training.

The six modules aim to help skilled practitioners think critically and make effective decisions on the basis of solid knowledge and understanding of these complications. When using the modules for basic midwifery programmes, it is understood that students should already be competent in most of the basic skills such as measuring blood pressure, performing a vaginal examination, conducting a normal delivery and prevention of infection.

The modules were released in 1996 and in 2007 have now been updated in line with recent evidence and the WHO clinical guidelines. Each module can be taught independently of the other modules. It is however advisable to work through all of them.

Educational material for teachers of midwifery

Teaching sessions that deal with the general issue of maternal mortality, the factors which contribute to the death and the importance of community participation in helping to make motherhood safer.

Sessions include information about:

• Hypertension
• The stages of an eclamptic fit
• Riskfactors, prevention and management
• Differential diagnosis
• Taking of blood samples
• Intravenous infusion
• Administering of drugs
• Insertion of a urinary catheter
• Care and observation during an eclamptic fit

Teaching sessions that include the physiology and management of the third stage of labour and postpartum haemorrhage. Skills covered include:

• Identification of risk factors
• Massaging the uterus
• Applying bimanual compression to the uterus
• Applying manual compression to the aorta
• Suturing of perineal tears
• Manual removal of the placenta

Teaching sessions that explain risk factors and offer guidance on how to use the partograph in monitoring labour and how to identify the signs of obstructed labour.

Skills covered include:

• Assessing pelvic capacity,
• Diagnosing presentation and position of the baby
• Assessing descent of the fetal head,
• Recognizing obstructed labour
• Performing vacuum extraction

An explanation of puerperal sepsis is followed by sessions dealing with underlying risk factors, identification and differentiation from other conditions

• Prevention and management
• Session on HIV and AIDS related to childbearing women
• Taking a midstream specimen of urine
• Taking a high vaginal swab
• Maintaining vulval hygiene

This module is based on WHO clinical guidelines for integrated pregnancy care and sessions cover routine care during pregnancy including screening tests, preventive measures and counselling as well as initial management of complications. Clinical skills include:

• Testing urine
• Performing RPR
• HIV-test and physical examination of the pregnant woman