Haaritha Boltman-Binkowski completed her B. Cur (Cum Laude) at the University of the Western Cape in 2003. She then gained clinical experience in both private and government institutions in the labour ward. She completed her Masters degree in Advanced Midwifery in 2005. In 2007 she started working as a lecturer at the University of the Western Cape. During the 13 years of lecturing, she has lectured various disciplines, including General Nursing, Midwifery, Advanced Midwifery, Neonatal Nursing, Research Methods, and Gender Based Violence as a Public Health Issue. She has co-ordinated both theory and clinical for many of the modules and year levels taught. Since 2015, Haaritha has been co-ordinating and teaching the Masters in Nursing: Advanced Midwifery and Neonatal Nursing. Haaritha is passionate about collaboration and has organised two international collaborative visits in 2019 from different institutions in Belgium (UC Leuven and VIVES), and has been involved with NEPAD efforts since 2012. In 2019 she graduated with another Masters degree in Nursing Education (Cum Laude). Her curriculum development experience covers micro aspects as well as developing the new graduate programme in Midwifery. Her clinical and teaching experience is as varied as her research interests but her focus areas are: maternal and child health, evidence-based practice, postpartum haemorrhage, teaching and learning and decolonisation.
Postpartum haemorrhage (PPH) is one of the most preventable causes of maternal death, yet it still ranks as one of the main conditions responsible for maternal mortality. PPH has serious adverse effects on maternal health including death, adult respiratory distress syndrome, coagulation disorders, shock, hysterectomy and loss of fertility. As bleeding after delivery is expected, women often do not realize the seriousness of their condition until it is too late and often do not survive to be referred to a more specialized level of care.
The diagnosis and management of PPH is complex, with the main challenge being the visual assessment of blood loss. As women are not able to warn healthcare providers timeously about their condition, the situation is compounded by poor clinical assessments, a lack of accuracy in diagnosis, lack of resources, and differing methods of treatment . Most of the primary maternity care in South Africa is provided by midwives, and the overall quality of care during the management of PPH is poor. In addition, the scope of practice of midwives is limited. Unless a registered midwife has a prescribing license, they may not administer any medications, with the exception of oxytocin. Midwives may also not perform any surgical interventions.
The purpose of this presentation will be to present evidence-based, effective, non-pharmacological methods of treating postpartum haemorrhage, which primary care midwives may find valuable in their practice.
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