The MANA Stats Fetal, Neonatal Mortality Review (FNMR) Project: Preliminary Findings and Implications for Practice

Wednesday, February 21, 2018 - 1:30pm to 3:00pm

 

A webinar with Dr. Melissa Cheney

In this webinar, cosponsored by MANA and NACPM, Dr. Melissa Cheyney will describe findings from a study designed to examine all fetal and neonatal deaths recorded in MANA Stats between 2004 and 2016. Using a modified Fetal-Infant-Mortality-Review (FIMR) approach, midwife-researchers conducted detailed interviews with midwives for all non-miscarriage fetal and neonatal deaths in the sample. The objective was to clarify the gestational age at which the death occurred and to properly classify late miscarriages.

The reviewers also collected qualitative data on when, how, and why the death occurred, as well as data on whether an autopsy was conducted, and the official cause of death assigned via medical examiner or coroner’s report. Using the three delays model as proposed by Thaddeus and Maine (1994), she discusses rates of intrapartum and neonatal death in a large sample of more than 50,000 planned, midwife-led, community births (home and birth center) in the United States. She will also provide an in-depth thematic analysis of the primary contributors to mortality in the sample.

Findings indicate that while the overall rate of death is low, there are three major contributors to fetal and neonatal mortality, including: 1) delays in the decision to transfer to the hospital due to failure to identify early signs of fetal distress and/or hesitancy to transport due to fear of “punitive cesarean section”; 2) delays in reaching care due to distance from the hospital or fractured collaborations with Emergency Medical Services; and 3) delays in receiving care once arriving at the hospital due to fear, poor inter-professional communication, blaming and shaming.
 

We hope you will join MANA and NACPM to hear this important information and participate in the discussion that will follow.

Date: Wednesday, Feb 21, 2018
Time: 1:30 - 3:00pm ET