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Improving Birth Outcomes Meeting the Challenge in the Developing World (2003) / Chapter Skim
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Appendix C: The Essential Competencies of a Skilled Birth Attendant
Pages 310-313

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From page 310...
... When the bleeding requires emergency care, skilled attendants can stabilize the woman by giving intravenous fluids and can transfer her to a referral facility. Sepsis: A skilled attendant should prevent infection by ensuring that the woman gives birth in a safe, clean environment, maintaining the highest possible standards of hygiene and infection control, and using clean or sterile equipment, including gloves.
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From page 311...
... If eclampsia occurs during delivery, skilled attendants can provide potentially life-saving care: administering anticonvulsant drugs, inducing labor by rupturing membranes, and correctly positioning an unconscious woman for delivery. Skilled attendants should also be able to administer anticonvulsant drugs and stabilize a woman to prevent her condition from worsening, and refer her for higher-level care.
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From page 312...
... In aciclition, skilled attendants with access to laboratory facilities can diagnose and treat anemia, malaria, and sexually transmitted infections; they can also provide counseling to encourage women to seek voluntary HIV testing, as well as advise mothers who have or suspect they have HIV/AIDS on infant feecling options. Skilled attendants can administer antiretroviral therapies, where available, to women with HIV, before or cluring delivery.
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From page 313...
... In the context of identifying essential competencies for skilled attendants, the International Confederation of Midwives has developed a "framework for decision-making." This framework calls on skilled attendants to take the following actions to ensure high-quality care: · Gather information through interviews, dialogue, observation, and clinical examination and decide what is relevant to the situations; · Identify signs and symptoms of serious and/or life-threatening conditions and develop a plan of care, balancing speed with attention to details; and · Evaluate the effectiveness of actions taken and modify or adapt the plan of care when needed, in individual cases and when a similar situation arises in the future. Excerpted with permission from Skilled Care During Childbirth Information Booklet.
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Key Terms

  • skilled attendant
  • appropriate measures
  • unsafe abortion
  • obstructed labor
  • anticonvulsant drugs

  • emergency care
  • rupturing membranes
  • moderately preterm
  • requires emergency
  • ectopic pregnancy

  • provide counseling
  • appropriate care
  • preventing neonatal
  • referral facility
  • prolapsed cord

  • including gloves
  • providing nutrition
  • attendants provide
  • prevent neonatal
  • encourage women

  • treat anemia
  • managing unsafe
  • identify prolonged
  • elevated blood
  • placental delivery

  • using active
  • addressing abortion
  • unconscious woman
  • cord traction
  • promote practices


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