In community birth, midwives take care of two patients; the mom AND the baby. Learn or refresh the skill necessary to assess fetal wellbeing
Approximately 140 million births occur every year worldwide. The majority of these are vaginal births among pregnant people with no identified risk factors for complications, either for themselves or their babies, at the onset of labor. Although midwives can risk assess clients in pregnancy, they may still experience a complication in labor. (Danilack V, Nunes A, & Phipps M, 2015). Because even in low risk populations, approximately half of all stillbirths and a quarter of neonatal deaths result from complications during labour and childbirth, all midwives need to be skilled at fetal heart rate assessments (Lawn JE, Blencowe H, Waiswa P, Amouzou A, Mathers C, Hogan D, et al., 2016).
Over the last two decades, the WHO has encouraged all countries to entice women to give birth in health care facilities to ensure access to skilled health care professionals and timely referral should the need for additional care arise. However, accessing labor and childbirth care in medically managed health care facilities and hospitals may not guarantee good quality care. Disrespectful and undignified care is prevalent in many facility settings globally, particularly for underprivileged populations, and this not only violates their human rights but is also a significant barrier to accessing intrapartum care services (Bohren M, Hunter E, Munthe-Kaas H, Souza J, Vogel J, & Gülmezoglu A, 2014). In addition, the prevailing model of intrapartum care in many parts of the world, which enables the health care provider to control the birthing process, may expose apparently healthy pregnant women to unnecessary medical interventions that interfere with the physiological process of childbirth.