"The cord is the child": meanings and practices related to umbilical cord care in Central Uganda

An exploratory study of women and midwives' perceptions of environmental waste management - homebirth as climate action

BACKGROUND

Inspired by observing midwives working with birthing women in Bali and at homebirths in Australia, this study explores the meanings associated with environmental waste at birth.

AIMS

The aim is to better understand how and why women and midwives from the homebirth community in Australia choose to manage waste generated during the birthing process. Babies across the globe are born without a carbon footprint and are united, no matter their location, by a future that will require an understanding of and action against climate change.

METHODS

This qualitative exploratory study investigated midwives' (n = 10) and women's (n = 10) perspectives on environmental waste generated from birth at home. Data were collected through semi-structured interviews and analysed thematically.

RESULTS

Three overarching themes were identified from the data. The first theme "There is minimal waste from birth at home" demonstrates participants' perception of the difference in waste generated by birth at home compared to birth in a hospital. The second theme, "Organic waste from homebirth is beneficial to the environment," spoke to participants' embeddedness and connections within their surrounding community environment. The third theme, "Formal education around managing waste at homebirth doesn't exist," indicates a lack of structured or official education or training programs available to individuals interested in learning about sustainable waste management practices during home birth.

CONCLUSION

Birthing at home has a low environmental impact as clinical waste is negligible. This research demonstrates a need to incorporate sustainable waste management into midwifery education while respecting midwifery practices in the home setting.

Perceptions, beliefs, and current practices regarding neonatal skin care and emollient use in eastern Uganda: a qualitative study

BACKGROUND

The skin is a major route of infection in the neonatal period, especially in low birthweight (LBW) infants. Appropriate and safe neonatal skin care practices are required to reduce this risk. The perceptions and beliefs of mothers and other caregivers towards various neonatal skin care practices in our setting have been documented. Data from Asia suggests that the application of emollient to the skin of LBW infants can promote growth, reduce serious neonatal infections, and potentially reduce mortality. This is the first study to explore the acceptability of emollients and massage as part of neonatal skin care in a low-resource setting in sub-Saharan Africa (SSA) that is representative of the majority of government health facilities in Uganda and many in SSA.

OBJECTIVE

To explore perceptions, beliefs, and current practices regarding neonatal skin care and emollient use in eastern Uganda.

METHODS

We conducted a qualitative study consisting of three focus group discussions (30 participants), eight in-depth interviews with mothers/caregivers of preterm and term neonates and 12 key informant interviews with midwives, doctors and community health workers involved in neonatal care, to explore the perceptions and practices surrounding neonatal skin care and emollient use. Data collected were transcribed and analyzed using thematic content analysis.

RESULTS

Mothers perceived that skin care began in utero. Skincare practices depended on the place of delivery; for deliveries in a health facility the skincare practices were mainly based on the health worker's advice. Vernix caseosa was often washed off due to its perceived undesirability and was attributed to sexual intercourse in the last trimester. Despite their deleterious attributes found in previous studies, petrolatum-based oils, petrolatum-based jellies and talcum baby powders were the most commonly reported items used in neonatal skin care. In our population, there was high acceptability of emollient therapy use; however, neonatal massage was treated with scepticism as mothers feared damaging the vulnerable neonate. Mothers suggested massage and emollient application be undertaken by health workers, if it becomes an intervention.

CONCLUSIONS

In eastern Uganda, the perceptions and beliefs of mothers/caregivers toward neonatal skincare influenced their practices of which some could potentially be beneficial, and others harmful. Emollient use would be easily accepted if adequate sensitisation is conducted and using the gatekeepers such as health workers.

“Do not detach the placenta from my baby's cord” - Lotus birth case series from Tanzania tertiary hospital

Introduction

Cases findings

Conclusion and recommendation

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Lotus birth in Tertiary hospital

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Rare case series of umbilical nonseverance

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Multidisciplinary approach