5^th World Congress on Midwifery & Womens Health October 01-02, 2018 Frankfurt, Germany

Biography:

Julia Sanders has combined teaching, research and midwifery practice for over 25 years and has extensive experience in the design and delivery of complex research studies into maternity care. Her current methodologies include randomised trials and the use of routine health data to answer research questions.  Julia is currently leading the UKs largest study comparing outcomes for mothers and babies following waterbirth and birth on land and has an interest in developing further work around maternal weight gain in pregnancy.

Abstract:

Background: Excess antenatal weight gain is associated with pregnancy complications and longer term maternal obesity. Although international guidelines on antenatal weight gain exist, women have reported information to be inadequate.  This presentation will explore the current evidence base in relation to gestational weight gain and present the results of a UK based study.

Aim: The PRAM study assessed the feasibility and acceptability of incorporating an individualised weight chart and midwife support using a motivational interviewing-informed approach, into antenatal care.

Method: Pregnant women were recruited by community midwives and provided with personalised weight (based on their BMI) to record pregnancy weight gain against a plotted range based on the IOM guidelines. Participating midwives were trained in a motivational interviewing-informed approach to discussing weight. Participants were followed up postbirth and weight charts reviewed. Participant qualitative interviews and midwife focus groups were conducted.

Results: Fifty two women were recruited across all BMI categories. Weight charts were obtained from 33 (63.5%) participants’ maternity notes; 29 participants (87.8%) had monitored weight ≥10 times throughout pregnancy and 4 participants (12.1%) had monitored their weight 1 to 9 times. Gestational weight gain was obtained for 41 participants (78.8%) and compared to IOM recommended parameters. Of these, 11 participants (27%) were in range, 19 (36.5%) were above and 11 (21.2%) below recommended parameters. Interviews / focus groups with participants and midwives revealed that the weight charts were generally acceptable to participants, but that midwives did not engage participants in discussions about their weight as part of antenatal care.

Conclusions: Monitoring of gestational weight gain in pregnancy is generally acceptable to women and could be incorporated into an antenatal weight management intervention. However, given current evidence careful consideration now needs to be given to establishing healthy weight ranges for pregnancy and the development of effective tested complex interventions for women.

Biography:

Sarah Chitongo is a Nurse and Midwife with 16 years of experience in all areas of Midwifery. She is also an experienced Senior Manager who left the National Health Service (NHS) as a Deputy Head of Midwifery. She has set up a High Dependency Unit (HDU) on a delivery suite. The aim of the HDU was to offer women and their families a consistently high level of individual, medical, and psychological care, delivered by staff who understood the physiology, pathology, psychological and cultural needs of BME obstetric groups and the wider community. There was initial anxiety on the part of midwives around the mechanization of care, but competence and confidence was developed through an informal structure that she developed. She is an ambitious manager who has built a reputation developing and motivating staff. The management style focuses on three main things; innovation, quality and staff. She has excellent leadership, communication and interpersonal skills with the ability to inspire confidence and build strong stakeholder relationships to ensure that the curriculum is at the forefront of knowledge and reflects the latest research insights and materials. Further roles within current position include generating and presenting annual management review reports as well as providing consultancy for academics within the department in relation to midwifery education.

Abstract:

The Black Minority Ethnic (BME) population has increased significantly over the course of the last three decades. They have more prevalent pre-existing medical conditions and have worse health outcomes. With the increase in births from this group, it is inevitable that midwives’ are increasingly caring for these women in High Dependency Units (HDU) on delivery suites and engage in a meaningful way with midwives’ in understanding their experiences of HDU care on delivery suite. Little is known about midwives’ competencies and experiences in caring for this group. Hence, we need to identify barriers that affect high dependency provision to BME patients. A mixed study using surveys to London based Trusts. Knowledge from this work will contribute to guidance on standardization of this area and identify areas of improvement. It will also reduce the fragmented care provision and encourage responsiveness to individual, family and cultural needs. Encourage services is to be organized more seamlessly to ensure ethnic minorities receive appropriate individualised maternity care.