#IDM2018 or ‘International Day of the Midwife’ falls on May the 5th of every year. The theme for 2018 in three languages is…
- Midwives leading the way with quality care
- Sages-femmes, ouvrons la voie avec la qualité des soins
- Matronas liderando el camino con un cuidado de calidad
Also… Every May is Ehlers-Danlos Syndrome (EDS) awareness month around the world.
As such….for #InternationalDayOfTheMidwife, and EDS awareness month… I shared 10 top tips for caring for women with hypermobile Ehlers Danlos Syndrome (hEDS) during pregnancy birth and beyond. These tips come from my latest paper, authored in partnership with Dr. Gemma Pearce (@GemmaSPearce) and Dr. Emma Reinhold (@DrEReinhold ), entitled …
Hypermobile Ehlers-Danlos Syndrome during pregnancy, birth and beyond
Here, we present care considerations for midwives and the multidisciplinary team caring for this unique subgroup of childbearing women. However, we hope that women with hEDS will also benefit from this paper, as they make decisions in partnership with their professional health care teams. You can read the press release from this paper here.
I would personally like to thank the board members of the British Journal of Midwifery for making this article FREE for all to read. I would also like to thank the Royal college of Midwives for sharing news of the article here…and the Nursing Times for sharing further news here.
So what can midwives do to maximize the quality of care given to women with hEDS throughout pregnancy birth and beyond?…First of all….Know the facts…
- There have been no prevalence studies since EDS received a major reclassification in 2017
- Earlier estimates from 2006 suggest a prevalence rate of 0.75-2% for hyper mobile EDS
- hEDS is the most common form of EDS
- Up to 78% of women with hEDS could also have a diagnosis of Postural Orthostatic Tachycardia Syndrome (POTS)
- POTS predominantly occurs in women of childbearing age
- EDS is considered to remain largely under diagnosed.
Tips for midwives
- Discuss individual needs with women, as no two cases will be the same. Do this early, and always in partnership with the woman and the wider multidisciplinary healthcare team.
- Consider early referral to obstetric, physiotherapy and anaesthetic teams in partnership with the woman.
- Consider the need for alternate maternal positioning during pregnancy, birth and beyond. To minimise the risk of injury, positioning should be led by the mother.
- As wound healing can be problematic, the use of non-tension, non-dissolvable, deep double sutures, left in for at least 14 days is advisable.
- Wait longer for local anaesthetics to take effect and consider giving maximum dosage. Always be led by the mother on whether pain relief is sufficient
- Always consider the significance of a routine observation in light of existing POTS and/or EDS symptoms
- Promote spontaneous pushing rather than directed pushing during birth
- Promote effective pain management and the use of therapeutic birthing environments to promote reductions in stress
- Consider additional joint support for newborns suspected of having hEDS
- Document all joint dislocations and bruising marks on the newborn from birth to avoid misdiagnosis and/or wrongful accusations of mistreatment.
Research into EDS and childbearing is in it’s very early stages. We hope to build on this work to make a difference for all women with hEDS during pregnancy, birth and beyond.
If you would like to follow the progress of this work going forward..
Follow me via @SallyPezaro; The Academic Midwife; This blog
Until next time…Look after yourselves and each other
