Putting tech­nol­ogy into child­birth

Daily Trust - - HEALTH - By Judd-Leonard Okafor

Giv­ing birth to a child is both painful and trau­matic, and the trou­ble dou­bles in re­source-poor set­tings where con­di­tions of fa­cil­i­ties are not op­ti­mum.

Is­sues with qual­ity of care, high ex­pec­ta­tions, dread and so­cial re­stric­tions keep many women from giv­ing birth in hospi­tals.

Even in more places, dis­tance from a fa­cil­i­tyif there is one can be a bar­rier.

New ap­pli­ca­tion, in­no­va­tions and twists to sim­ple things as a labour bed holds out the prom­ise to ease dis­com­forts in child birth and makes hospi­tals eas­ier to man­age.

De­liv­ery stool

The tra­di­tional im­age of giv­ing birth in many places is a woman ly­ing on her back or half re­clin­ing while push­ing.

A de­liv­ery stool hopes to make more po­si­tions pos­si­ble-sit­ting, squat­ting, kneel­ing, as many as any woman is com­fort­able while giv­ing birth.

A pro­to­type de­vel­oped by the Marketing for In­ter­na­tional De­vel­op­ment (M4ID) was on ex­hi­bi­tion at the Women De­liver Con­fer­ence in Copen­hagen, the largest in­ter­na­tional gath­er­ing of stake­hold­ers in women’s health and gen­der is­sues.

The stool, made of col­lapsi­ble ma­te­rial, folds into the shape and size of an av­er­age suit­case for easy move­ment.

“We also de­signed it for emer­gency de­liv­ery,” said Da­maris Ro­driguez, ser­vice de­signer for Helsinki-based M4ID.

Even on cor­ri­dor­sand in sit­u­a­tion where di­la­tion is op­ti­mum and a baby just has to come out.

Un­like the av­er­age hos­pi­tal bed, a pro­to­type de­liv­ery bed comes thin­ner and in three steps. An ad­justable bar over the mid­dle pro­vides some­thing a woman can hang onto. The cush­ion pad­ding is cut to fit against a woman’s knees and thighs, while she rests her foot on a lower plat­form.

M4ID has pushed its work to Nige­ria and Kenya, but it tested its pro­to­types in Ibadan and Akure, specif­i­cally the Mother and Child Hos­pi­tal that has be­come a model hos­pi­tal in Ondo State’s bat­tle to re­duce ma­ter­nal and child mor­tal­ity.

Ondo State Health Com­mis­sioner, Dr Ade­dayo Adeyanju, said the re­sult of the trial was good be­cause they sim­u­lated life.

“We were able to have ev­i­dence for all our ac­tions and then for­mu­late bet­ter poli­cies,” he told Daily Trust in Copen­hagen.

Ondo is us­ing its Mother and Child Hos­pi­tal as model to try out any rel­e­vant in­no­va­tion in its bid to “have a state where preg­nancy will not be a death sentence,” said Adeyanju.

Cen­tre of space

Dif­fer­ent labour po­si­tions are still an on­go­ing con­ver­sa­tion, as many mid­wives are not trained to de­liver in cer­tain po­si­tions. But ac­tive labour is all about space and com­fort and mak­ing women be the cen­tre of the de­liv­ery space, ac­cord­ing to Ro­driguez.

“When we think about the de­liv­ery mo­ment, usu­ally what hap­pens is the mid­wife is fo­cused on the mother. There are key data she needs to record. She has her hands full and-for clean­li­ness and safe­ty­can’t touch any­thing else apart from the mother.”

Hand-gloved, with­out a part­ner or pen, how does a mid­wife record data while man­ag­ing an ac­tive labour. The so­lu­tion is a wall­mounted record­ing bar she can punch with an el­bow. The bar keeps a time stamp of all records.

“The idea is: ‘‘when we fin­ish, this in­for­ma­tion is safe and the health worker can check. If you need to re­mem­ber all that data in your head, it can be re­ally dif­fi­cult,” ex­plained Ro­driguez.

I De­liver

An­other pro­to­type be­ing im­ple­mented in Kenya is I De­liver-an ap­pli­ca­tion that can fit an en­tire health facility into a palm-held tablet.

Ro­driguez said: “Imagine a pa­per­less facility. Try to imagine this tablet to sup­port all the process of pa­per doc­u­men­ta­tion”.

But it is beyond pa­per. At present, M4ID is fo­cus­ing on the sec­tion that bundles a hos­pi­tal ma­ter­nity unit onto an app. Mod­ules dis­play pa­tient data from first an­te­na­tal visit to child­birth-in­for­ma­tion, med­i­ca­tion, at­tend­ing health worker, med­i­cal his­tory.

Some mod­ules are able to sug­gest a next crit­i­cal ac­tion on pa­tient-call a doc­tor, in­crease fre­quency of checks-based on data put into it over time.

Other sec­tions of the app give facility over­view, show­ing staff strength, de­ploy­ment,who’s ar­riv­ing or de­part­ing.

Ro­driguez de­scribes it as an in­tel­li­gent system that makes you work bet­ter. It is not just en­ter­ing data but do­ing things with the data.

And things with the women, too. A woman’s ex­pe­ri­ence is ex­pected to have moved from qual­ity of care (what in­fra­struc­ture was present) to qual­ity of ex­pe­ri­ence of the care after she goes through the de­liv­ery process.

It is at the heart of Re­spect­ful Ma­ter­nal Care pro­po­nents are push­ing for­re­spect, op­tions, clear com­mu­ni­ca­tion about ev­ery­thing in the birth process.

App to mea­sure qual­ity of care and ex­pe­ri­ence are still in the mak­ing, and its mak­ers are still work­ing with the World Health Or­gan­i­sa­tion (WHO) to de­fine what ex­actly should be mea­sured and how.

WHO is ex­pected to re­lease qual­ity-of-care stan­dards, but they will be ne­go­ti­ated at cru­cial cross­roads be­tween what fa­cil­i­ties of­fer and what com­mu­ni­ties de­sire.

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