gms | German Medical Science

Background: Young children need reliable relations in order to develop according to their needs. If families with children are permanently exposed to stressful situations, it may significantly reduce the child's chances to develop in good health, particularly in cases when families suffer from a lack of resources at the same time [1][2]. In the international literature factors are described which may pose a risk to a child's development. A high potential to identify risk factors for the child's health at a very early stage after birth is given by the outpatient care services of self-employed midwives [3].

Objective: The aim of this contribution is to illuminate the extent of risk factors detected by midwives in the population of women and infants that are being cared for by midwives during the postpartum period. The specific care of these families by the midwife will be described, and it will be explored if there are any differences in care between families that are more respectively less disadvantaged.

Method: In order to answer the research questions we analysed the data collected in 2014 by the self-employed midwives of the Swiss Confederation of Midwives (SHV). This survey provides an extensive source of data, however, some constraints have to be taken into account, particularly a lack of clear definitions in the survey. The degree to which our results can be generalized is therefore limited.

Results: Our contribution shows how often risk factors in mothers and newborns occur according to the data of the midwives. To describe the risk factors we use specific statements of midwives on women and infants (e.g. low level of education, difficult financial situation, single parenthood, health of mother and infant). It is shown as whether or how the care of the midwife is more intense in families with multiple risk factors. The information on the duration and intensity of care by the midwife during the first days and weeks postpartum as well as referrals of woman and infant by the midwife to other professionals (e.g. psychologists, psychiatrists, and gynaecologists) are chosen as indicators to describe the care by the midwife.

Relevance: Long lasting family strains may significantly affect the child's development. Midwives can make an important contribution to the early recognition of risk factors and to the prevention of health and psychological harms in the child and in the mother.

Conclusion: The results provide evidence of the incidence of risk factors in mothers and infants in Switzerland during the postpartum period and their impact on the care provided by self-employed midwives. Recommendations for further research are derived.

Ethical criteria: The data collected by the midwives are recorded anonymously, therefore no inference to single individuals can be made.