Background
Traditionally, the midwife has had low status in Georgia, even though evidence has shown that excessive involvement of doctors in normal labour leads to over-medicalized care and unnecessary medical interventions. The midwives at Tbilisi Maternity Hospital #5 are still struggling with the legacies of Soviet medicine and have experienced difficulties due to lack of skills in key areas of maternal and newborn health care.

About the project
This project was created to strengthen the role of midwives through training and task-shifting. The project team trained the hospital’s midwives on performing vaginal examinations, active management of third stage labour and the use of a partograph. The staff from the maternity ward were also trained on aorta compression methods to prevent excessive bleedings during childbirth. After completing the trainings, the midwives started practicing their newly acquired skills under the supervision of obstetricians/gynaecologists, before performing their new tasks independently in their daily work.

Results
By the end of the project, the role of the midwives had been strengthened dramatically in the labour management at Tblisi Maternity Hospital. Shifting the tasks between the doctors and midwives led to increased confidence and job satisfaction among the midwives and relieved the doctors of their heavy workload. Empowering the midwives with new skills also had a positive effect on the care given to the mothers in labour. Partograph use increased from 63% to 92% and the use of the aorta compression method reduced the rate of heavy blood loss and the need for blood transfusions. The success of this project inspired a similar project at another maternity clinic at Tblisi Referral Hospital.

Year: 2010