The module opens with the story of Mrs X, which shows how certain social, economic and cultural factors, combined with delays in seeking medical care, put mothers at risk of complications which frequently lead to death. These topics are then further elaborated in the remainder of the module, with special emphasis being placed on the role that midwives can play in promoting safe motherhood in the community. Specific topics covered include the place and value of women in society, traditional beliefs, practices and taboos affecting the health of women during pregnancy and childbirth, the recognition and reduction of risk factors, and the concept of delay as it relates to maternal death. Additional sessions cover the use of community profiling for planning community-based care and the evaluation of its effectiveness. Learning methods used include story telling, community visits to assess conditions and collect data, role play, practical exercises, and simple but instructive games.
Students then learn what postpartum haemorrhage is and how it occurs.
Skills covered include identification of risk factors, management of the third stage of labour, massaging the uterus and expelling clots, applying bimanual compression to the uterus, and applying manual compression to the aorta. Other sessions explain how to suture perineal tears, suture an episiotomy, repair cervical and high vaginal tears, and remove the placenta manually. The opening session reviews fundamentals of anatomy and physiology relevant to the management of obstructed labour. Subsequent sessions explain risk factors and offer guidance on how to identify the signs of obstructed labour. Special emphasis is placed on use of the partograph in monitoring labour.