''Guarding the Standards and Continuity of Perinatal and Postnatal Care'' Project (2015/2016)
The project is an advocacy for making Perinatal and Postnatal Care Standards a life-reality, including making a midwife-led care a fully available option for Public Health Fund patients. Our project is a continuation of the Foundation's struggle of many years to introduce unified standards of medical care, based on Patient's Rights and modern medical processes in Poland.
Decision-makers are our action's target. This is augmented by building a coalition of patient's support organizations and leading an awareness-raising campaign addressed to women (rights of pre-and postnatal patients). Although the newest care directive is considered to be a medical benchmark and indeed is legally binding, most of medical care facilities do not treat it as such. The conclusion based on the 2012 Audit, lead by our Foundation, is that most providers do not even attempt to follow the directive's guidelines. The Polish NHS and Ministry of Health have failed to create a system that would monitor execution of the directive and that would audit the performance of the medical supervisors in this regard. The directive is based on WHO's guidelines. It guarantees an equal standard of care for all women (provided by the Polish National Health Fund) and it validates Patient's Rights as a vital part of standards of care. In line with these guidelines, each and every woman has the right to prenatal education, care of community midwife, access to a non-pharmacological pain relief during childbirth, freedom in choosing birthing position and in intake of fluids. Additionally, midwife can be the main carer for the mother and newborn (provided she is certified to give such care).
1. The Project is focused on advocacy and intervention, aiming to introduce a systemic change. At the first stage, in order to be successful, a powerful campaign to improve the standards of care is needed. It's vital to analyze which rules and regulations make a publicly funded midwife-led care a challenge and to collate data concerning waiting time for an obstetric consultation.
– Legal analysis of regulations pertaining to midwifery as a profession.
– Monitoring accessibility of Public Health Fund Care during pregnancy
– Advocacy and intervention based on the collated data (petitioning and campaigning with the decision makers – the results will be published on our website)
– Organizing a coalition of patient's support organization, especially those related to child care and patient's rights as well as midwifery.
– All activities aiming at making the current directive a reality as well as making a midwife-led care a widely accessible options (which has been our Foundation's aim since it's beginnings. It's also the reason why we are developing our support in legal counseling, which runs parallel to our educational campaigns)
2. Women-Centered Educational Campaign. The Campaign aims at increasing awareness and knowledge about Patient Rights of prenatal and postnatal mothers. We aim to introduce the most important parts of the directive to the patient population. We are also going to engage the local activist groups in organizing ''The Week with Dignified Birth'' during which local educational and informative meetings will be organized.
Where to Give Birth – Our Portal: www.GdzieRodzic.info
Website called www.GdzieRodzic.info was set up in 2012. It is one of the most important outputs of our Foundation. It forms a bridge between two vital areas of interest: monitoring and advocacy for the highest standard of prenatal and postnatal patient care as well as expectant parent-focused education.
Our aim was to provide the parents with answer to the question we hear the most: ''Where should I give birth?''. Thanks to our website, it is possible to find a medical facility most local to the mother, compare statistical data such as the number of episiotomies and c-sections performed as well as learn what's the facilities pain-relief offer. You can easily check what accommodation the hospital offers, if active birthing is allowed, is skin to skin fully implemented, what care is offered prenatally and if breastfeeding support is available. If you were looking for a birthing school, this information is also included as well as documents that you need to bring on admission/ procedures that you will face then. These and other insights are helpful in choosing the most optimal birthing facility for you.
www.GdzieRodzic.info delivers solid information that is not only based on the medical facility's self-assesment but also reviews done by real-life punters. Mothers who gave birth in a given location are free to verify its claims directly on the portal and provide their own opinion.
The website is also educational – we publish articles discussing pregnancy birth and early motherhood. We also inform patients on their rights. A dictionary of terms most frequently used in midwifery is another important resource.
The content of the website was verified in 2014. 2015 is going to bring a refurbishment of the entire portal, to make it more accessible for our reviewers (among others, we will extend our rating scale and create a closed-question survey). This also means that an indepth analysis of mother care in Poland willl be much easier to create.
Monitoring and Audit
The Foundation's mission is directly realized by monitoring and advocacy.
Despite the self-declared government support, pregnancy and motherhood put women at risk of marginalization – especially employment-wise. Birth results in less disposable income. Additionally, access to legal assistance and information on the right medical care is an issue. Financially challenged mothers are discriminated against when seeking for the appropriate medical are; it's not unheard of illegal payments for medical services to be elicited from them.
The Foundation constantly monitors adherence to patient's rights in midwifery units. A detailed report and a special guidebook for medical professionals was published on the basis of this activity: ''Best Practices. How to Respect Patient's Rights'' (Przykłady dobrych praktyk. Jak przestrzegać praw pacjenta"). We have also published two analyses, one pertaining to patient's rights and another to implications of being a professional midwife.
These were not the only activities undertaken. The foundation campaigned for the birthing schools offer to be refunded by the Polish NHS as well interventions when medical benefits were taken away from the most impoverished patients.
• Strive to protect and improve human and patient rights especially in the context of midwifery
• Monitor the activities of public institutions in regards to medical care of prenatal and postnatal mothers
• Monitor the process of implementation of legal directives in regards to patient's rights and evidence based medical care.
• Advocacy for women rights as patients and employees
• Facilitating access to information and legal assistance for pregnant women and mothers of young children
• Empowering women as patient and consumers of medical care as well as increasing their awareness of their rights.
The latest reports: Education is our basic statutory goal. Ever since the Foundation was established, educational offer, aimed at medical professionals was present. Conferences, workshops and publications are our constant focus.
Conferences, we have been organizing since 1997 , have become our tradition. These annual occurrences are a great opportunity to discuss midwifery from a holistic, rather than solely medical, perspective. Topics discussed are always the hottest off the press – and usually the ones glossed over in traditional education. Not only medical professionals but also psychologists, neurobiologists, anthropologists and sociologists speak at the conferences. We debate about the dilemmas in prenatal and postnatal care, needs of mothers, the role of the midwife in pre- and postnatal care as well as cascades of interventions. Additionally, we promote and explain what ''evidence based care'' is all about.
Our educational offer is directed at midwifes, doctors and widely understood birth supporters. Our Foundation also offers workshops for birthing instructors, community midwifes and hospital-based midwifes or those from neonatal units. Training in how to assist a homebirth are also provided. Publications, promoting the most up-to-date knowledge and helpful guidelines are also prepared by our team. So far, we have published booklets discussing the most important aspects and processes of mother and baby care after and before birth. Topics raised, are among others: episiotomy, first contact with the infant, pain relief, emotional aspects of pregnancy, birth and motherhood as well as induction of labour.
''You know, you choose. Make Your Own Birth Decisions'' is a motto of our educational endeavors aiming at encouraging active participation of patients in their own care. The focus is to empower women to express their needs and make conscious decisions in regards to procedures and techniques employed by medical facilities. We have published special leaflets discussing the most frequently encountered interventions at birth: episiotomy, epidural, skin to skin and birthing positions.
A series of leaflets on patient's rights - '' Mums Have Rights'' – was also created. It explains employee and patient's rights of the mother.
According to PR experts, our '' Childbirth with Dignity'' campaign was the most effective campaign aimed at the society as a whole. The campaign has initiated very positive changes in midwifery and obstetric units across the country. ''Childbirth with dignity'' became a slogan commonly used in every day situations. Women were empowered to share their birth stories – and this has not only lead to a domino effect of changes in medical facilities but also made a huge imprint in the hearts and minds of those who work with mothers every day.
The contributions from mothers resulted in a comprehensive survey of almost all medical facilities in the country. They were ranked in accordance to WHO guidelines as well as patient's rights. A special Guide was published, where each facility was given a description and patient assessment of excellence. The campaign aimed to promote patient-centered care and thanks to this initiative, family births are now possible, the birthing mothers were given the freedom to move and assume self chosen positions as well as have skin to skin with the baby. So far, the campaign has happened in 1994. 1995, 2000 and 2006.
MLEKOTEKA Project – Breastfeeding Assistance for Mums
The Project aims at promotion of infant breastfeeding. Feeding newborns, infants and small children is an emotive issue. Regardless of convictions, it's a known fact that mother's milk is the most superior food for the little ones. However, lack of knowledge and support, sometimes prevents successful breastfeeding.
Increasing awareness and knowledge in regards to qualities of breast milk, promotion of breastfeeding, explaining that the milk is much more than a meal, resolving doubts and queries as well as integration of community that supports breastfeeding – these are the main goals of our project.
Mlekoteka consist of a series of regional meetings (in Poland and abroad) during the Breastfeeding Promotion Week (May) as well as year-round meetings of lactation support groups. Click here to find out more.
Organizers: Childbirth with Dignity Foundation, Maminiec, Doula dla Ciebie (www.maminiec.eu, www.douladlaciebie.pl). If breasfeeding is in your interest or you would like to know more, you are very welcome to join the project.
We are curious about your experience – regardless of how you feed your baby. Become involved, share your story with others and take part in our workshops and meetings. Our groups and meetings are inclusive and open – no matter what choices you took.
Tłumaczenie: Hanna Skomra