"Enhancing Perinatal Outcomes In Gestational Diabetes Mellitus: A Midwifery Facilitator Based Approach"

Introduction: Gestational diabetes mellitus, or GDM, is a metabolic disorder that affects both expectant mothers and their developing fetuses. It increases the chance of several pregnancy and delivery complications. Babies born to women with gestational diabetes mellitus (GDM) are at risk for perinatal death, fetal macrosomia, low blood sugar, birth trauma, and congenital malformations. This paper explores the possibility of enhancing perinatal outcomes in GDM by applying a midwifery facilitator-based approach. Objectives: This study's primary objective is to assess the impact of a midwife facilitator-based approach on the management of gestational diabetes mellitus (GDM) and its associated complications in expectant mothers and their babies. Our objective is to create a midwifery facilitator approach model that provides recommendations for clinical practice. Methods: A prospective cohort study involving 111 mothers compared standard care with care led by midwives. The intervention group was chosen based on their preferences, and they received full support, which included education, lifestyle modifications, and assistance for mothers. A certified diabetes educator led the classes, which covered a variety of subjects like multiple pregnancies, chronic illnesses, and absences. Group 1 comprised 62 mothers who attended classes and follow-ups, while 49 mothers in Group 2 did not attend any of them. Consistency and low turnover were assured. Results: The Midwifery Facilitator-Based Approach, which considers psychological, emotional, and physical factors, fully manages GDM. Strict diabetes management, nutritional counseling, promoting a healthy diet, and aiding in stress reduction are all made possible by these midwives. They empower mothers with GDM to take care of themselves and allow informed decision-making, potentially improving perinatal outcomes and the general well-being of GDM-affected families. Conclusion: A promising strategy for improving perinatal outcomes in GDM is the facilitator-based approach used by midwives. It offers a treatment plan that is holistic in nature, taking into account the relationships between various aspects of health. By integrating midwifery into GDM management, we can enhance mothers' empowerment and comprehension, which will ultimately benefit moms and their infants

Perceived Stress, Quality of Life and Pregnancy Outcomes Among Women with Hypertensive Disorders of Pregnancy (HDP) And Role of Midwives in It: A Systematic Review

Hypertensive disorders during pregnancy are one of the leading causes of maternal & newborn death across the world. Many of the hypertensive antenatal women often end of with admission to ICU due to severe pre-eclampsia and eclampsia, or delivering dead babies of term pregnancy, even if live baby delivered, they mostly admitted to NICU due to respiratory distress and prematurity. Hence, they need continuous educational intervention and follow up by healthcare personnel. And a midwife is the right person for this. Midwives play an important role in encouraging pregnant mothers to adhere to treatment through various education and follow up resulting in safe pregnancy outcome among these mothers. But in Indian scenario in many places the role of midwives are often ignored while managing pregnancy complications. Therefore, current paper aimed to explore the expanded role of midwives in identifying the affected quality of life and its impact on pregnancy outcome among women with HDPs. The empirical research papers of various countries were searched through the electronic databases like Pro-Quest, Embase, Research Gate, Science direct, PUBMED, MEDLINE, CINAHL-EBSCO, web of science, Google Scholar etc and the references were also searched of those primary articles. A total of 15 out of 275 studies including both RCTs, Systematic & narrative review papers were analysed. In this paper 4 relevant points were analyzed, like- perceived stress, quality of life (QOL), pregnancy outcomes and role of midwife in GHTN management in rural India. The research papers on pregnancy outcomes as well as stress and QOL secondary to gestational outcome were plenty, but very less studies were retrieved on role of midwives. Mother’s with GHTN has more stress regarding the fetal wellbeing which ultimately affects the quality of life. Interventional studies revealed reduction in stress and improved perinatal outcome secondary to some integrated midwifery management approach. More research on addressing quality of life and exploring the stressors and interventional programs by midwifes are recommended to bring solution to this problem. The result of this review can be incorporated into nursing research to empower the women with gestational hypertension to have a positive pregnancy experience