08. KEYNOTE :: Autonomous Midwife-led Continuity Of Care: Evidence-based, Respectful Care Within A Collaborative Model

Vijaya Krishnan

Speaker: Vijaya Krishnan

Facilitator: Linda Wylie

Recording: HERE

KEYNOTE: Research over the past few years has focused not only on maternal and infant mortality, but also the quality of the care provided, and respectful maternity care as a human right. Research also tells us that antenatal childbirth preparation, which includes childbirth classes and one-on-one counselling has positive effects on the course of labor and delivery, as well as higher rates of breastfeeding. Studies on outcomes of mothers receiving continuous labor support, tell us that she has a higher chance of vaginal birth, less interventions, less C-sections, better start to breastfeeding, less postpartum depression, and an overall better maternal experience. The WHO currently highly recommends Midwife-Led Continuity-of-Care models, in which a known midwife or small group of known midwives supports a woman throughout her antenatal, intrapartum and postnatal period, as a way to improve at least 50 different short-term and long-term outcomes, as well as provide respectful, safe and satisfying maternity care.

This presentation describes the current state of maternity care in India, with nearly 85-90% C-section rates, and lack of respectful, evidence-based care being the norm. India is also a country where there are both extremes of care “Too little, too late”, and “Too much, too soon”. In such an environment, this presentation aims to tie in the benefits of excellent Autonomous Midwife-Led Continuity of Care, within a Collaborative Model of Care (CMC), with in-house Emergency Infrastructure and Consultants. This is a model which we have honed to near perfection over the last 12 years.  Our statistics serve as a proof of the efficacy of this Model of Care – 92% Natural Birth rate, 90% VBAC rate, 100% VBA2C, Twin Natural Births and many Breech Births – and, these numbers are inclusive of mothers with complex needs like GDM, PIH, etc.

It will describe how this CMC can be replicated, and how any facility with specifically trained, professional and specialist Midwives, can create a Birth Environment similar to The Sanctum Natural Birth Center.