Core skills and abilities of Skilled Birth Attendant (SBA)
As recommended by WHO, ICM and FIGO all medical students will be able to acquire core midwifery skills. According to the National Policy on Skilled Birth Attendant these skills are also incorporated in the curriculum of IOM.
Objectives of SBA
Students will be able to
- communicate effectively to provide holistic “women centered” care.
- take history, perform physical examination and specific screening tests as required, including voluntary counseling and testing for HIV, and provide appropriate advice/guidance.
- educate women and their families about the importance of making a birth plan (where the delivery will take place, how they will get there, who will attend the birth and, in case of a complication, how timely referral will be arranged).
- assist pregnant women and their families to make a plan for birth.
- identify complications in mothers and newborns, perform first line management (including performance of life saving procedures and administration of life saving drugs according to the national protocol when needed) and make arrangements for effective referral.
- perform vaginal examination and interpret the findings.
- identify the onset of labour.
- monitor maternal and fetal well-being during labour and provide supportive care.
- record maternal and fetal well-being on a partograph, identify maternal and foetal distress and take appropriate action, including referral where required.
- identify delayed progress in labour and take appropriate action, including referral where appropriate.
- manage normal vaginal delivery.
- manage the third stage of labour actively (using oxitocic drugs, clamping and cutting the cord, and applying controlled cord traction).
- assess the newborn at birth and give immediate care.
- identify any life threatening conditions in the newborn and take essential life saving measures including where necessary, resuscitation as a component of the management of birth axphyxia, and referral as appropriate.
- identify haemorrhage and hypertension in labour, provide first line management (including life saving skills in emergency obstretic care where needed),’ and if required make effective referral.
- provide postnatal care to women and their newborns and post abortion care where necessary.
- assist women and their newborns in initiating and establishing early and exclusive breast feeding, including educating women and their families and other helpers in maintaining successful breastfeeding.
- identify complications (illnesses and conditions) detrimental to the health of mothers and their newborns in the postnatal period and provide first line management according to the national clinical protocol, and if required make arrangements for effective referral.
- supervise non-skilled and semi-skilled attendants, including TBAs, MCHWs and paramedics, in order to ensure that the care they provide during pregnancy, childbirth and early postpartum is of good quality.
- provide advice, counseling and services on postpartum family planning and refer if needed.
- educate women (and their families) on how to prevent sexually transmitted infections including HIV.
- collect and report relevant data, collaborate in data analysis and case audits.
- promote a sense of shared responsibility/partnership with individual women, their family members/supporters and the community for the care of women and newborns throughout pregnancy, childbirth and postnatal period.
- use vacuum extraction in vaginal deliveries.
- perform manual vacuum aspiration for the management of incomplete abortion.
- repair vaginal tears.
- perform manual removal of placenta.
References:
- Textbook of Obstetrics- DC Dutta, New Central book agency.
- Textbook of Gynaecolgy- DC Dutta
- Shaws Textbook of Gynaecology.
- Holland & Brews text book of Obstetrics.
- Dutta’s textbook of Obstetrics
- Intigrated Management of pregnancy and childbirth, A guide for midwives and doctors WHO
- Maternal and Newborn Care, Learning Resource Package- NHTC Supplementary References for SBA
