Better Birth Outcomes From Individualized Care
Mothers and babies have better birth outcomes when their care is tailored to their needs, according to a new report.
On February 15, 2018, the World Health Organization (WHO) issued “WHO Recommendations: Intrapartum Care for a Positive Childbirth Experience,” which contains global care standards for healthy pregnant women, with aims to reduce unnecessary medical interventions.
WHO estimates that 140 million births happen annually. Most births do not have complications for women and their babies. However, for 20 years or so, practitioners have been increasing interventions that were previously only used to avoid risks or treat complications, such as oxytocin infusion to speed up labor or cesarean deliveries.
Using such interventions unnecessarily can, in some cases, increase risks for those delivering and their babies, WHO said. A safe and healthy first labor does not usually last longer than 12 hours, and subsequent labors should not usually last more than 10 hours.
However, each birth and each person are different, and, thus, previous benchmarks for cervical dilation rates may be unrealistic for some women and should not be used in identifying women at risk of adverse birth outcomes. The guidelines emphasize individualization throughout pregnancy planning, delivery, and postpartum care.
New global care standards for healthy pregnant women and births from the World Health Organization aim to reduce unnecessary medical interventions.
Photo by Tatyana Tomsickova, courtesy of iStockphoto.
—Lindsey Wahowiak
Read the full article in The Nation’s Health at http://thenationshealth.aphapublications.org/content/48/3/13.1
Rhode Island Correctional Program Tackles Opioids
Rhode Island is taking a unique approach to tackling opioid overdoses by addressing misuse among one of its most vulnerable populations: inmates.
In 2016, the Rhode Island Department of Corrections launched a treatment program to screen and treat all inmates in the system for opioid addiction. Inmates are provided medication-assisted treatment while incarcerated and also receive care once they are released, helping them stick to a plan that will keep them from misusing opioids.
Early results have been exceptional, research shows. In the first year since its implementation, the treatment program led to a 61% decrease in postincarceration overdose deaths, according to a study published in February 2018 in JAMA Psychiatry.
Incarcerated populations with opioid use disorder are especially prone to overdose because they do not have access to opioids and lose the tolerance they have built up, said study coauthor Josiah Rich, MD, professor of medicine and epidemiology at Brown University and director of the Center for Prisoner Health and Human Rights at Miriam Hospital. Once they are released, inmates then experience high rates of overdose. It may also be difficult for people who have been incarcerated to cope with life after the routine of jail or prison, Rich added.
There are few interventions in place similar to the program in Rhode Island, which stands out for several reasons. One is its use of medication to treat opioid addiction: methadone, buprenorphine, or naltrexone. The program also hinges on connecting people to support once they have left the system, which gives people a greater chance of managing opioid use disorder. Without assistance after incarceration, the program could not be as successful, Rich said.
—Julia Haskins
Read the full article in The Nation’s Health at http://thenationshealth.aphapublications.org/content/48/3/11.1