Innovations for Traditional Midwifery
Heart Strings: Internationally accepted best practices such as monitoring fetal heart rates throughout pregnancy and delivery can make the difference between an infant who lives and an infant who dies, a mother who makes it to the hospital in time and a mother who does not. Studies by the World Health Organization show that pregnant women who receive intermittent fetal monitoring have dramatically reduced rates of infant mortality. It is not realistic to expect that Western conventions such as fetascopes will work to monitor fetal heart tones in an area where most of the health attendants cannot count. Additionally, fetascopes and dopplers are expensive in relation to Ugandan incomes and therefore dependent on foreign donation, which is not sustainable. Depending on government funded health units to monitor pregnant women means that the majority of women who live far from city centers, do not have access.
At Mother Health International we have created a color-coded bracelet called the Heart String, which allows health attendants, who cannot read or write, to monitor fetal heart tones and pulse in pregnant women and infants. Attendants listen to the FHT and press a bead each time they hear a ‘beat’- after fifteen seconds, they will look at where they have landed on the bracelet. If they are in the white section, the FHT is too low. The Green, the FHT is in a range of normal. The Red, the FHT is too high. Detailed instructions (both verbally and through images) on what to do in each instance come with the Heart Strings.
Over the last two years we have used Heart Strings with 25 illiterate traditional midwives and have been overwhelmed by the success. Midwives who previously could not tell the difference between a high risk mother and a low risk mother were suddenly able to make appropriate medical decisions prior to a bad outcome, thereby avoiding catastrophe and saving lives.
The Heart Strings cost about $1 to manufacture and are based on traditional Ugandan methods of counting the days of the moon on a string to determine fertility. Because of this, they are easily understood and accepted by traditional midwives. Additionally, they can be worn on the arm at all times, so traveling attendants will always have the tool with them. The Heart String is a sustainable and life saving tool that is culturally appropriate to the regions that it serves.
At Mother Health International we have created a color-coded bracelet called the Heart String, which allows health attendants, who cannot read or write, to monitor fetal heart tones and pulse in pregnant women and infants. Attendants listen to the FHT and press a bead each time they hear a ‘beat’- after fifteen seconds, they will look at where they have landed on the bracelet. If they are in the white section, the FHT is too low. The Green, the FHT is in a range of normal. The Red, the FHT is too high. Detailed instructions (both verbally and through images) on what to do in each instance come with the Heart Strings.
Over the last two years we have used Heart Strings with 25 illiterate traditional midwives and have been overwhelmed by the success. Midwives who previously could not tell the difference between a high risk mother and a low risk mother were suddenly able to make appropriate medical decisions prior to a bad outcome, thereby avoiding catastrophe and saving lives.
The Heart Strings cost about $1 to manufacture and are based on traditional Ugandan methods of counting the days of the moon on a string to determine fertility. Because of this, they are easily understood and accepted by traditional midwives. Additionally, they can be worn on the arm at all times, so traveling attendants will always have the tool with them. The Heart String is a sustainable and life saving tool that is culturally appropriate to the regions that it serves.
