Putting technology into childbirth
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.
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.
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.