Midwifery and Neonatal Care
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January 07, 2025   09:00 AM GMT

Webinar onMidwifery and Neonatal Care

Early Bird Registration End Date: Dec 15, 2024
Abstract Submission Opens: Dec 02, 2024

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Latest News

Breastfeeding after COVID-19 vaccination is safe, with minimal changes to milk composition

2024-12-19 - 2024-12

In a recent study published in The Journal of Nutrition, a group of researchers investigated whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or coronavirus disease 2019 (COVID-19) vaccination induces compositional changes in human milk, including the presence of vaccine components.
Background
Human milk is the gold standard for infant nutrition, offering essential nutrients, immune cells, and immunomodulatory components that protect infants with immature immune systems. While it reduces infections, it can transmit certain pathogens such as human immunodeficiency virus (HIV) and Ebola virus.
Initial concerns about SARS-CoV-2 transmission via human milk disrupted breastfeeding practices despite later evidence showing no transmission and clear immune responses in milk after infection. However, limited data exist on how SARS-CoV-2 infection and COVID-19 vaccination impact milk composition.
About the study
Participants in this study were lactating individuals aged 18 years or older who either tested positive for SARS-CoV-2 or received a COVID-19 vaccine. Milk samples from vaccinated participants were included if they had no history of SARS-CoV-2 infection and were scheduled to receive the Pfizer, Moderna, or Johnson and Johnson (J&J) vaccines.
Milk was self-collected at specific intervals before and after vaccination using clean containers, with collection procedures approved by the Mount Sinai Hospital Institutional Review Board (IRB). For participants with SARS-CoV-2 infection, milk samples were collected within seven days of a confirmed positive test, with collection procedures approved by the University of Idaho IRB.
Study results
Study participants ranged from 26 to 41 years old, with a mean age of 32 years, and were between less than one month to 30 months postpartum, with a mean of 8 months postpartum.
Milk samples were analysed using multi-omics approaches, including proteomics, metabolomics, and lipidomics, after extraction via the MPLEx method. Significant compositional changes in milk proteins, metabolites, and lipids were identified in association with SARS-CoV-2 infection and compared to baseline control values. However, for COVID-19 vaccination, samples were compared with prevaccine milk from the same participants, as no preinfection samples were available for those with SARS-CoV-2 infection.
Investigations into the presence of vaccine components in milk found no detectable synthetic lipids or adenoviral proteins in any samples, indicating that vaccine components do not enter human milk.
Conclusions
To summarize, there is a global consensus that the risk of contracting COVID-19 via human milk feeding is negligible, while the benefits of breastfeeding during and after infection or vaccination are substantial. Vaccination effects on lactating individuals are mild, with no evidence of harm to infants consuming milk from vaccinated mothers. While trace amounts of vaccine messenger Ribonucleic acid (


Women in labour turned away from maternity wards over staff shortages

2024-12-17 - 2024-12

Almost 1,000 women have been turned away from maternity units while in labour in recent months, alarming figures show.
Midwives said expectant mothers were being forced to endure "distressing" searches for a bed as hospitals battled short staffing.
Freedom of Information responses show 925 incidents in which women in suspected or confirmed labour were diverted to a different hospital from their chosen place of birth.
The data, which covers six months, come from 68 of approximately 120 trusts with maternity units, meaning the true figure is likely to be significantly higher.
Some women were sent vast distances in the search for a maternity unit that would take them.
One who was due to give birth at Watford General Hospital in Hertfordshire was sent to West Suffolk Hospital, some 83 miles away.
Three women due to give birth at Chesterfield Royal Hospital in Derbyshire faced lengthy journeys.
One ended up at Grimsby Hospital in Lincolnshire, a distance of 77 miles (124km), while another was sent to York Hospital, a journey of 70 miles (112km), and a third sent 60 miles (96km) to Oldham Hospital in Greater Manchester.
The data gathered by Health Service Journal covers January to June this year.
Figures on diverts have not been collected on a national scale since 2016, when 382 diversions were reported over a year.
It follows a warning of a shortage of 2,500 midwives, which the Royal College of Midwives says is threatening safety.
The three organisations recording the highest number of diverts to different trusts were all in Greater Manchester and surrounding areas.
Bolton NHS foundation trust had 62 diversions, while Tameside and Glossop Integrated Care Foundation trust had 39, and Northern Care Alliance Foundation trust had 38.
Greater Manchester Integrated Care Board, which is responsible for care across the area, said: "We recognise that for women and birthing people choosing a hospital to give birth in is a big decision, and when this changes, it can feel difficult and upsetting.
"Staff across the NHS will always ensure women get the best care and treatment they need, with diverts only used as a last resort on the grounds of safety."
Three-quarters of diverts to different NHS trusts were due to short staffing, or lack of sufficiently trained staff to cope with the cases incoming. Most trusts tried to divert to hospitals within their local area.
'Distressing change to birthing plan'
Fiona Gibb, the director of professional midwifery at Royal College of Midwives' (RCM), said: "Decisions to change a woman's admission plan, diverting her care or temporarily closing a maternity service is not one that is taken lightly but taken on the grounds of safety.
"The RCM supports and respects these often-difficult decisions made by midwife managers to ensure safety and effective maternity care for women and their babies.
"However, we understand this can be distressing for some women to have their plans changed."
She said trusts struggling


Maternity care in Ghana is meant to be free, but it's not - and many can't afford it

2024-12-10 - 2024-12

Globally, over a quarter of a million women a year die during pregnancy or childbirth. Sub-Saharan Africa accounts for about 70% of these deaths.

In Ghana, the rate of maternal deaths is 263 per 100,000 births. Although this maternal mortality rate is much lower than the average for African countries (532 per 100,000 births), progress is being threatened by the financial difficulties mothers face accessing maternal healthcare services in the country.

Ghana's health system has offered free maternal healthcare since 2008 under the Ghana National Health Insurance Scheme. But many families are still compelled to pay for these services.

As researchers in maternal health and health economics, we conducted a study in two regions of Ghana looking at the extra expenses mothers with newborn babies and their households face when seeking maternal healthcare.

We found that about 32% of households spent more than 10% of their total household expenditure on maternal healthcare services - including antenatal services, delivery and postnatal care.

This can strain household's budgets, affecting the ability to afford other basic needs including food, clothing and shelter. In some instances it may force mothers to forgo treatment due to an inability to pay.

Interviewing mothers
We surveyed 414 mothers in the Ashanti and Upper West regions of Ghana.

Previous research on out-of-pocket payments for maternal health services relied on household survey data.

We interviewed mothers directly as they left the hospital. This allowed us to get more accurate information about the actual out-of-pocket payments they were forced to make.

The Ashanti region is located in the southern half of Ghana and is the country's second most urbanised and prosperous region. The Ashanti region also has the highest active public national health insurance membership, of about 2.2 million members.

The Upper West region in the north-west is one of the least urbanised and poorest regions in Ghana. This region has the lowest active health insurance membership at 0.47 million.

We chose these two regions as they represent a diverse range of socioeconomic conditions. A good balance between a relatively prosperous urban area and a poor rural setting.

We collected the data through exit interviews at both public and private healthcare facilities. We wanted to understand the financial challenges faced by mothers across various settings and service providers.

Out-of-pocket payments
Our research found that 97% of mothers made an out-of-pocket payment for antenatal care; 65% paid for delivery services; and 22% paid for postnatal services. These expenses raise questions about the effectiveness of Ghana's free maternal healthcare policy.

These payments are often informal and linked to coping strategies implemented by health providers in response to delays and inadequate reimbursements, shortages of essential supplies and mother's insufficient knowledge of services cove


NSW maternity staffing changes spark concern among midwives, expectant mums

2024-12-13 - 2024-12

Pregnant nurse Teagan Beeby felt "pure fear" when she was told about midwifery roster cuts at her workplace.
She is 36 weeks pregnant and works at Port Macquarie Base Hospital, where she also intends to give birth to her first child.
"As a nurse, knowing the impact that [nurse to patient] ratio has on the care that you can give … [and] becoming a patient myself, it's quite a scary experience," Ms Beeby said.
"You want to go to your local hospital knowing you can be looked after and you're going to have somebody there to take care of you and your baby when you're in a very vulnerable state."
Nurses and Midwives Association (NMA) Port Macquarie branch president Mark Brennan said roster changes would lead to two rather than three midwives rostered per day shift at the hospital from mid-January.
But a Mid North Coast Local Health District spokesperson denied that claim and said the rosters were being updated to improve continuity of care in the maternity unit.
"There will be no reduction in midwifery staff as a result of the roster changes," a spokesperson said.
However, the ABC has been told by the union and midwives from Port Macquarie Base Hospital that the changes to midwife day shift rostering from three to two were communicated at a recent staff meeting.
Christmas transfers
NMA Port Macquarie said the changes to the roster at the hospital were coming ahead of a move that would see all high-risk maternity patients transferred to Port Macquarie from Kempsey District Hospital for 10 days from December 20.
The association said in January high-risk maternity patients would be transferred to Port Macquarie between 5pm on Thursdays and 7am on Mondays.
The health declined to confirm whether these arrangements were in place, but said a shortage of specialists had necessitated the transfers in January.
Kempsey mother Sarah Lipscombe met with hospital management about the distress caused by the weekend bypasses during her recent pregnancy.
"Every Friday, Saturday, Sunday as you approach the birth, not knowing where you will be or if you will be transferred with lights and sirens is a fear that I cannot put into words," she said.
'Breaking point'
Concerns have been raised on the NSW Central Coast that the critical shortage of maternity staff could see expectant mothers sent to Sydney or Newcastle.
In an extraordinary meeting this week Gosford Hospital's executive told the Staff Medical Council that its obstetrics and gynaecology services were at risk of going on bypass.
Women will be notified if they cannot be supported at Gosford Hospital.
NSW Health data shows Gosford Hospital is the second-busiest maternity hospital outside Sydney.
Central Coast mother Zoe Zoaretz, whose second child is due in February, is concerned how local women will be impacted.
"The last thing a person in labour needs to deal with is to be transported far from where they are supposed to be giving birth, and it is a scary prospect," she said.
NSW Health Minister


Maternity care praised by mums in survey

2024-12-16 - 2024-12

Health officials have welcomed news that East Lancashire's maternity services have been recognised as being amongst the best in the country.
A total of 120 NHS trusts took part in the 2024 Maternity Survey and 18,951 women who gave birth in February 2024 responded to a Care Quality Commission (CQC) survey.
East Lancashire Hospitals Trust (ELHT) was rated "better than expected" after 156 new mothers who gave birth in the delivery suite at Lancashire Women's and Newborn centre or midwifery-led units at Rossendale, Blackburn and Burnley took part.
Chief executive, Martin Hodgson, said the results were "positive for local parents and a testament to the hard working maternity team".

'Supported and heard'
The survey looked at all aspects of maternity services, including antenatal care, care during labor and birth and post-natal care.
Patients praised ELHT for allowing partners to stay with them as much as they wanted, taking their concerns seriously, and being able to get help from staff when needed.
Mr. Hodgson added: "There is a lot of hard work from the team across all our maternity settings to deliver these amazing results and I am so proud of everything they have achieved for local parents and children.
"To know people felt supported and heard is very positive indeed."


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