The death of a mother and her baby during birth this week is a matter of great concern.

It’s comforting to note that Permanent Secretary for Health Philip Davies has promised an inquiry.

We hope the inquiry will include:

• A review of the protocol the maternity unit uses to deal with high-risk cases. If it is lacking then it needs to be strengthened to ensure that the safety of mother and baby is paramount. Documentation is an essential part of this protocol. It not only contains the medical history of women, it reminds professional staff that they cannot afford to overlook it.
• The competency of midwives in knowledge and skills on the maternity floor. When a pregnant woman enters the maternity unit, the midwives should be able to do the basic checks and detect any abnormality. If the review finds that they don’t have the skills or knowledge then they need to get retrained to bring them up to par with the acceptable level of competency. If it’s purely medical negligence then appropriate disciplinary action needs to be taken.
• The referral process between midwives and pediatricians in emergency situations is absolutely important. High risk cases are matters of life and death. Communication between midwives, who do the initial assessment, and pediatricians is vital. If it is late or delayed it could compromise the safety of mother and baby.
• The attitude of maternity staff towards pregnant women makes a big difference. We hope that the old practice of women being harshly spoken to by rude midwives has long gone because we now live in the 21st century.

Last but not the least; the ministry should now seriously think of starting a separate midwifery stream at the School of Nursing.  When they graduate, they will become midwifery specialists who can deal with high-risk cases within their scope of practice.

The outcome will be skilled midwives at our maternity units. Hopefully, this will reduce and eventually eliminate preventable maternal and infant mortality rate.

NEMANI DELAIBATIKI

Feedback:  nemani.delaibatiki@fijisun.com.fj