Midwives Saving Lives: Skills Training Update In Ghana...and babies

A blog entry from first-time Project HOPE volunteer, Jennifer Oh, a certified nurse midwife from Lawndale Christian Health Center in Chicago, Illinois

One of the goals for Project HOPE's mission in Ghana was to conduct a training for midwives that was held at Effia Nkwanta Regional Hospital in conjunction with the Nursing Midwifery Training College. The Regional Health director selected specific hospitals/health centers in the region to send a couple of their midwives to the training. They were sent letters of invitation and we had 16 participants the first day.

From the start of the training, I was quite impressed with the level of experience of our participants. Their experience ranged from one year out of school to as many as 28 years of experience as a midwife.

Most of them are in positions of leadership or administration at their respective hospitals/health centers and/or are in teaching positions at 2 of the local midwifery colleges. From our introductions, I knew that I was going to learn more from this training than I was going to be able to teach! It was both a humbling and inspiring feeling for me to know that I had close to 80 years of midwifery experience in the room! Therefore, it was great that from the onset, we established a collegial relationship and reaffirming the idea that this training was going to be mutual exchange of ideas and experiences as well as hopefully serve as an update for clinical practice.

It was hopeful for me to see such a breadth of experienced midwives willing to come and have a posture of learning. As often in the U.S. as well, sometime there is a gap between clinical practice and the knowing the reasons behind certain clinical practices. It was wonderful after the pre-eclampsia lecture, one of the participants who had 15 + years of experience shared that she had been managing pre-eclampsia/eclampsia but never fully understood the reasons behind the management steps. We also were able to share a great conversation about the practice of routine episiotomies on primiparous (first-time mothers) mothers and about female genital mutilation and how to care for these women. Another important topic that created a lot of discussion was the clinical practice of administering Rhogam for rhesus negative women. Currently, Rhogam is being given (not routinely) but after delivery of the baby in the postpartum period.

After reviewing the physiology of Rh isoimmunization and the purpose of Rhogam, there began a healthy discussion of changing practice to administering Rhogam earlier at 26-28 weeks gestation (which is the standard of care in the U.S.).

It has been a privilege to meet these women who are working and serving the women of Ghana with very low resources. I have grown an intense respect and admiration for the participants in this training and see the potential for practice change that can potentially make an impact on maternal and neonatal mortality in Ghana.