Midwifery Refresher and Respectful Care Update Course

April 19th and 20th we helped Cathy and Micky, facilitate the Midwifery Refresher Course for nurses from Dhaulagiri Zonal Hospital and newly trained SBAs (skilled birth attendants) from rural and remote areas of Nepal. Two MIDSON trainers, Amala and Asha, were also facilitating as well as the departing head nurse and one of the SBA trainers. It was great to have a local expert, Debi teach the condom tapenade, a life saving procedure that can be used to treat Post Partum Haemorrhages that are unresponsive to medications. This is similar to the bakri balloon that can be used in the same circumstances.

The condom tapenade station. 

The topics covered in the course were:

• Respectful childbirth
• Slow delivery of the head
• How to use the somersault maneuver for a nuchal cord
• Comfort measures and positions for labour and delivery
• Breech delivery
• PPH
• Hypertension
• Pre-eclampsia
• Condom Tapenade
• MVA (Manual Vacum Aspiration for incomplete miscarriage, retained products postpartum and comprehensive abortion care)
• Helping Babies Breathe
• Immediate care of the newborn emphasizing skin to skin and breastfeeding in first hour

On the morning of the second day, two of the nurses shared with us that they conducted two deliveries last night using slow delivery of the head with no tears. They were so happy and giddy while explaining the two births to us. This is so exciting to us because it is still routine to give all women an episiotomy during childbirth, especially nulliparous women. We are hopeful that these three young nurses will change the face of care in their hospital.

There was time on both days for presentations on respectful treatment of women in general and also in the childbearing years.

The respectful childbirth presentation by MIDSON was especially important as in Nepal women have few choices during childbirth. For example they are not given the option to have a labour companion or partner in the delivery room or choice of positions. Stories abound in Nepal of women being physically and verbally abused during childbirth.

The nurses and SBAs were keen participants. We enjoyed laughing and learning together with them.
We taught slow delivery of the head, comfort measures and positions for labour and delivery, how to use the somersault maneuver for a nuchal cord, and Immediate care of the newborn emphasizing skin to skin and breastfeeding in first hour. By the end of the day the two of us had birthed dozens of babies through our birthing pants!

Mickey and Cathy presented each of the SBA's with the book "Where Women Have No Doctor" in the Nepali language. This book has been translated into many languages and given to people providing care to women all over the world with limited resources. These books are written by the Hisperian Foundation. To learn more check out their website: http://hesperian.org/

We wrapped up the two day workshop with a short little dance party and photoshoot. We played the song Sisters by a Tribe Called Red and invited the participants to dance with us. This song was chosen by the Canadian Association of Midwives as the song to dance to this year on International Day of the Midwife, on May 5th.

The SBA's and nurses wrote these ideas about respectful childbirth.