Nursing students listened attentively to speakers during International Midwifery Day, celebrated this month at the University of the Western Cape (UWC). Image: Shelley Christians/UWCObstetrical emergencies - those critical moments during pregnancy or childbirth - pose significant risks to both mother and baby, sometimes leading to permanent injury or even death. The importance of recognising and managing these emergencies was highlighted during International Midwifery Day, celebrated this month at the University of the Western Cape (UWC).
The event underscored the need for rigorous training for midwifery students, emphasising how negligence in high-pressure situations can have serious legal consequences. Experienced practitioners shared their insights with the students, illustrating the real-world implications of poor clinical judgment and inadequate preparedness.
Registered nurses with midwifery training can work in labour wards or neonatal wards, but they must practice under specific regulations. They have certain limitations, and some procedures such as instrumental deliveries, must be performed by doctors.
Advanced midwives who have completed postgraduate studies are allowed to perform more advanced procedures such as vacuum-assisted and forceps deliveries that regular midwives cannot.
Private midwives often have advanced midwifery qualifications and can provide care, including home births, under specific regulations. They can prescribe certain medications and refer patients to affiliated doctors or hospitals if complications arise.
Home births with private midwives are becoming increasingly popular as they can provide a more comfortable and supportive environment for the mother, with family members present to assist during labour.
UWC Nursing Department Convenor and lecturer, Sr. Valerie Doughty, spoke about the critical skills midwives must possess, including the ability to detect complications early, perform emergency resuscitation for both mother and child, and provide in-womb care during foetal distress: “They must be able to spot any problem, perform resuscitation on both mother and baby if needed, and provide care inside the womb if the baby is in distress.”
Third-year nursing student, Temicka Thomas, a Belhar resident, said, “The words of the accoucheur (a male midwife) really stuck with me: that I could go to jail as a student, should anything go wrong because of neglect on my part. This made me realise the importance of my role in society, and it motivated me even more to be thorough in my future job as a nurse.
“The presentation by the president of the Society of Midwives of South Africa (SOMSA) made me realise the responsibilities of the profession. It makes sense now: I'll be handling high-schedule drugs, and I basically have to run a hospital ward. It gave me a better perspective of the people working behind the scenes; the policies, education and regulations, and I could benefit from hearing about the personal experiences of a midwife in private practice.”
University of the Western Cape nursing students gathered to engage with guest speakers in celebration of International Midwifery Day. Image: Shelly Christians/UWCSr. Doughty explained that preparing students sufficiently is an essential part of our training, but often, they are not exposed to clinical situations during placement, making it challenging to acquire the necessary skills and experience.
“Ideally, we would want them to respond to situations that require an immediate response in an obstetrical emergency. It is crucial for midwives-in-training to be competent in managing such situations,” she said.
To remedy this challenge, Sr. Doughty’s colleague and fellow lecturer, Dr Jeffrey Hoffman, who coordinates the clinical programme in their department, suggested implementing innovative skills development opportunities by linking the midwifery skills training with the augmented and virtual reality simulated learning opportunities. This could provide students with a simulated environment that mimics emergency situations during childbirth and addresses challenges with clinical placements.
“To address this issue, it is crucial for students to develop skills and competence towards the management of obstetrical emergencies through simulated learning. It provides students with a real experience in a simulated environment that mimics real-life situations. Simultaneously, this approach bridges the gap between theoretical knowledge and practical experience, ensuring that midwifery students are better equipped to handle critical situations when they arise, said Dr Hoffman.
Accoucheur Sydney Grove was a guest speaker at the event.Guest speaker, Sr. Marijka van de Merwe, a midwife in private practice, told students that women migrated more towards using midwives as they realised they did not want medicalised care and unnecessary interventions.
“Homebirths have been on the rise since the early 2000s, and more moms are educating themselves about home delivery and are becoming aware of the opportunity to opt for a home birth. There is definitely an opportunity for new homebirth midwives, which also creates an opportunity for self-employment.
Images by Shelly Christians
