Timely and qualified obstetric care is the key to the health of the mother and newborn baby

loss of consciousness. Why is it important to seek medical attention immediately if these signs occur in pregnant women?

‘When a pregnant woman has high blood pressure and lower limb oedema, it is midwives who can play a key role in assistance. They can measure blood pressure and closely monitor the patient's condition, assessing for other symptoms such as headaches or visual changes that may indicate pre-eclampsia,” notes Alexei Klimashkin, an international trainer who has trained midwives from five secondary and tertiary obstetric organizations as part of a UN South-South Cooperation project implemented by the Ministry of Health of the Kyrgyz Republic and the United Nations Population Fund (UNFPA). 

This project aims to reduce preventable maternal morbidity by accessing quality health services through the use of obstetric surveillance response and telemedicine in maternity hospitals. 

Pre-eclampsia occurs in 5% to 8% of pregnant women and is responsible for 76,000 maternal and 500,000 infant deaths worldwide each year, making it one of the leading causes of pregnancy-related mortality.

As the expert shares, if any alarming symptoms are detected, midwives consult with a doctor to develop a further treatment plan: “Midwives can help women to lower blood pressure, advise on how to manage oedema and headaches, and provide additional advice on maintaining a healthy lifestyle. All these measures are aimed at reducing risks among mothers and babies and ensuring a safe pregnancy and delivery”.

There are only 2,196 midwives in Kyrgyzstan, 90 percent of whom work in maternity hospitals providing reproductive and maternal health services. 

It is midwives who are the first to meet pregnant women at the maternity hospital. It is very important to correctly assess and diagnose severe pre-eclampsia and, as part of a multidisciplinary team, to initiate timely care. And as part of the project to provide quality reproductive and maternal health services, midwives improved their knowledge and skills at a three-day training for five pilot health care organizations, namely Osh Interregional Integrated Clinical Hospital, Jalal-Abad Regional Clinical Hospital, Issyk-Kul and Chui Regional Integrated Hospitals and the Perinatal Centre of the National Centre for Maternal and Child Health in Bishkek, with the participation of an international expert.

One of the training participants, Elnura Kubanychbekova, a midwife at the Maternity Hospital of Jalal-Abad Regional Clinical Hospital, noted that following the competencies is primarily about improving the quality of midwives' work, improving services for patients, and protecting the rights of medical staff. 

Regular participation in educational seminars, trainings and conferences will help keeping up to date with the latest advances and techniques in midwifery: “Midwives in Kyrgyzstan are striving for professional growth and development. And it is important to support the aspiration to study modern scientific research, and the introduction of evidence-based medicine into practice will improve the quality of care provided. Then the labor of midwives will be rewarded by the gratitude of patients and the respect of colleagues,” Alexei Klimashkin shares his opinion. 

Through the training, midwives were able to improve their knowledge and skills both in theory on national midwifery competencies in midwifery, neonatology, public health and ethics, which form the basis of high quality, culturally relevant and appropriate care for women and newborns, and through simulation sessions on prevention of hemorrhage after delivery, management of pre-eclampsia and eclampsia. 

It is important to note that the second and third days of training were conducted by the midwives themselves, trained by an international expert. This means that each health care organization now has a trained trainer (five in total) to conduct regular on-the-job training on prevention of postpartum hemorrhage, management of pre-eclampsia and eclampsia before referral to hospital. 

At the end of the training, the international expert shared his positive impressions of working with midwives in Kyrgyzstan: ‘They are true professionals who demonstrate a deep commitment to their work every day, care for patients and willingness to work with limited resources. Their strengths include a high level of empathy, the ability to make quick decisions in emergency situations, and a commitment to creating a comfortable and supportive environment for women during pregnancy and labor’.

Written by: Gulaiym Shigaibaeva 

<shigaibaeva@unfpa.org>