The focus of this issue of the Journal of Midwifery and Women's Health is “Low Tech, High Effect: Caring for Women and Infants During Disasters.” By its very nature, a disaster means that events and consequences have occurred that require assistance beyond the ability and resources of the affected population. During the aftermath of a disaster, people from near and far offer their assistance. Some volunteers have much needed skills. Most have good intentions. However, not every pair of helping hands is actually helpful in the midst of a disaster response. The expertise of a health professional may be functional in high-tech environments, but might not be practical in low-resource settings. Communities affected by disasters often experience a period of limited access to resources. Services and supplies may be destroyed or rendered unavailable due to lack of electricity, or unreachable due to closed roads or lack of transportation. When resources are limited, providers need to rely on interventions that use basic or minimal technologies. Disaster training and preparedness can provide health professionals with an orientation for learning new skill sets and adapting existing skills for effective care in low-tech environments. In the midst of the initial chaos and focus on finding affected people and triaging the wounded, life cycle events continue. Pregnant women go into labor and need someone to assist them through the birthing process. Women and their infants deserve safe, effective care in disaster settings. The articles presented here share current knowledge of effective care for women and infants in disaster or low-resource settings. Practitioners are provided with an introduction to disasters, disaster response, and disaster preparedness in the article by Gwen Brumbaugh Keeney, CNM, PhD. Naeema Al Gasseer, RN, PhD, Elissa Dresden, RN, ND, Gwen Brumbaugh Keeney, CNM, PhD, and Nicole Warren, CNM, PhD(c), focus the readers' attention on health service and policy issues affecting women and infants in complex humanitarian emergencies, such as war and drought. Judith O'Heir, NM, MN, describes approaches for maternal and reproductive health service delivery in refugee and displaced populations. Doulas or supportive birth companions, providing low-tech interventions that benefit childbearing women in stressful circumstances, are discussed by Debra Pascali-Bonaro, CD, CPPD, BEd, and Mary Kroeger, CNM, MPH. Riccardo Davanzo, MD, PhD, provides the evidence-based data for neonatal interventions that can be used in low-resource settings. In-depth descriptions of neurohormonal stress responses and mediating multimodal interventions for infants, including massage, acoustic, and rocking stimuli, are presented by Rosemary White-Traut, RN, DNSc. Additional resources are listed to facilitate access to disaster literature and information about organizations involved in disaster policy, service delivery, and training. Two informational resources are provided for clinicians to use and/or share with parents and other disaster responders: 1) a delineation of basic steps to manage a birth when there are no skilled attendants, and 2) strategies for assisting young children to help them cope with their disaster experiences. Midwives and women's health nurses can draw upon their existing knowledge and skills that use minimal intervention to achieve positive outcomes. The interventions presented in this issue are consistent with being “with women” to facilitate optimum care and perinatal outcomes, whether in high-resource, developed country birthing facilities or low-resource settings, such as developing country rural health posts or communities affected by disasters. Knowing what simple technologies are effective and developing the skills to implement those interventions can increase the quality of care in the midst of adverse circumstances.
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Jul 1, 2009
Dominic Montagu + 1
Open Access
