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Back 8 October 2012

XX FIGO (International Federation of Gynecology and Obstetrics)

ICM President Frances Day-Stirk reinforced the indispensable role of midwives at the panel discussion Born Too Soon this morning.


Frances said promoting autonomous midwives as the most appropriate caregivers for childbearing women and their newborn, and quality midwifery services, was the most effective means of achieving MDGs 4 & 5 for child survival and maternal health.
She re-affirmed the commitment of ICM to working towards enhancing the reproductive health of women, and the health of their newborn, including preventing preterm birth and care for premature babies.


In answering questions to the panel, Frances Day-Stirk said ICM has carefully and formally defined the role of a midwife; from pre-conception care; care of the newborn; to during birth and antenatal. Frances said the scope of midwifery practice is detailed in the ICM Essential Competencies. These answer the questions “What is a midwife expected to know?” and “What does a midwife do?” and importantly they are evidence-based.


She said Midwifery Associations were role models, and ICM was working with developing associations, which were key at the local level to improving maternal and newborn health. Midwives can mentor other health workers.
She said ICM was advocating and lobbying on behalf of women, working to sow the seeds for the right education, providing the tools and standards that can assist.


“Professional organisations such as ICM can support and liaise with Ministry of Health and governments, recognising the importance of good health systems, supporting governments in health system design.”
“Some of the challenges the profession faces right now were personal circumstances of midwives; and on the ground inadequate housing; poor nutrition; lack of support systems and access to services.”


Frances Day-Stirk told participants:”There was strong supporting evidence of the benefits of midwifery care. Midwifery care is impactful and sustainable: invest in an educated, regulated competent midwifery workforce and get a good return on your investment .


Born Too Soon: The Global Action Report on Preterm Birth (Published May 2012) provides evidence that preterm birth is on the rise in most countries and is the second leading cause of death global for children under five after pneumonia.
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8 October 2012 Rome | How to accelerate progress on prevention and care
From The Partnership (PMNCH)


Chaired by PMNCH Director Dr Carole Presern and obstetrician and epidemiologist Dr José Belizán, this FIGO 2012 session discussed key findings and next steps from Born Too Soon: The Global Action Report on Preterm Birth published in June 2012 – the first ever report providing country estimates of preterm birth around the world.


Since 2005 we have known that premature birth was the leading cause of neonatal deaths. Born Too Soon shows the extent to which preterm birth is on the rise in most countries, and is now the second leading cause of death globally for children under five, after pneumonia.


“We really have a problem on our hands here, and we don't have a lot in our armamentarium to deal with this,” warned panelist Dr Joy Lawn, Director of Global Evidence and Policy with Save the Children’s Saving Newborn Lives program and a key author on the report. “The obstetrics community has a key role to play in reducing preterm births,” she said.

Care all depends on where you're born, she explained; the gap between low- and high-income countries is less than 10 percent survival vs. more than 90 percent. Forty million births happen at home and of those 5.6 million are born preterm.


The good news is more than 70 percent of preterm babies could be saved without going to full intensive care. For instance, Kangaroo Mother Care – wrapping an infant to mom’s chest to prevent hypothermia – halves neonatal deaths for preterm babies < 2000 gm (comparative to incubator) at little to no cost.


“We could save 450,000 babies every year,” she said, except that not enough physicians are using this intervention.
“We think we have technology instead – but this can work with technology.”
Birth spacing can also be scaled up. “And the converse is also true,” said Dr Lawn. “There is excessive risk if interpregnancy interval is too long.”


Adolescent pregnancies have a higher correlation with premature birth, still birth, low birth rate and asphyxia.
“We recognize that being overweight or obese doubles risks as well,” Dr Lawn added.
Aga Khan University's Professor Zulfiqar Bhutta, also speaking on the panel, said more focus is needed on women's education as a preterm birth prevention.


“Forty-one percent of pregnancies are unplanned,” he said, which is also a preterm risk factor.
In her closing remarks at the event, PMNCH Director Carole Presern stressed the role health workers must play to address these challenges and utilize proven interventions.


“We must work with communities where preterm birth is still a burden,” she said. “Your place of birth should not determine your right to life.”


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