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Kathy Thomas-Elbourne

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Even though maternal and neonatal deaths in T&T are on the decline, calls are being made for more midwives to be hired.

In an interview with Guardian Media, public relations officer of the T&T Midwives Association (TTAM), Kathy Thomas- Elbourne said one of the main challenges in the public health system was the shortage of midwives.

“Midwives can help to substantially reduce maternal and neonatal mortality due to their expert training,” she said.

Giving a breakdown of statistics, Thomas-Elbourne said, “The maternal mortality rate in 2020 was 21.129 deaths per 1000 live births which represented a 1.98 per cent decline from 2019.”

She added, “The infant mortality rate in 2019 was 21.555 deaths per 1000 live births, a 1.94 per cent decline from 2018.”

She noted that there were many misconceptions about labour.

“Some of these are that the woman has to eat for two or that eating Milk of Magnesia will give the baby light skin and eating ochroes will allow the bay to slip out the birth canal without pain,” she added.

Thomas-Elbourne said all new mothers must seek antenatal care from 12 weeks of pregnancy, take antenatal iron and folic acid, eat healthily and drink lots of water whilst getting adequate rest.”

Saying sometimes midwives are not given their due respect, Thomas-Elbourne said, “I would like to see more respect for midwives and the roles they perform. Midwives have skills and competencies to manage clients with normal pregnancies in line with the recommendations from the International Confederation of Midwives.”

She noted that “Ideally it should be one midwife to one client.”

Giving praise to T&T’s public health institutions, Thomas-Elbourne said all of the public health institutions had personnel dedicated to caring for mother and baby.

She said, “Childbirth classes are conducted by T&T Association of Midwives (TTAM) every Saturday from 10 am to 12 noon virtually via the zoom platform since the COVID-19 pandemic.

Previously they were held face- to- face at our building the Venus Mark Learning Resource Centre. Our classes are delivered in eight-week cycles covering topics such as Prenatal & Postnatal exercises, baby layette and bathing of baby, labour and delivery, the role of the support person, breastfeeding, postnatal care and baby massage.”

Thomas-Elbourne said TTAM has 275 members who work in public, private and independent practice throughout T&T.

“Our vision is to be a premier organization empowering and representing midwives, strengthening families and building communities,” she added.

She noted that 95 per cent of all births in T&T are done at public institutions by midwives.

“The percentage of women who have a natural birth is 95 per cent. The birth rate for T&T in 2020 was 12.453 births per 1000 people, a 2.54 per cent decline from 2019,” she added.

Despite the fundamental role they play in delivery, Thomas-Elbourne said midwives do not give epidurals nor perform caesarian sections.

“ Midwives are trained to identify complications and alert the obstetrician. Midwives can refer clients to obstetricians if we anticipate problems. Our role includes examining and monitoring pregnant women, assessing care requirements and writing care plans, undertaking antenatal care in hospitals, homes and GP practices, carrying out screening tests, providing information, emotional support and reassurance to women and their partners,” Thomas-Elbourne said.