Self-care and remote care during pregnancy: a new paradigm?
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(2020) 18:107
COMMENTARY
Open Access
Self-care and remote care during pregnancy: a new paradigm? A. Metin Gülmezoglu1, Anne Ammerdorffer1* , Manjulaa Narasimhan2, Alyce N. Wilson3, Joshua P. Vogel3, Lale Say2 and Özge Tunçalp2 Abstract Self-care interventions and remote care offer innovative and equitable ways to strengthen access to sexual and reproductive health services. Self-isolation during COVID-19 provided the opportunity for obstetric facilities and healthcare providers to integrate and increase the usage of interventions for self-care and remote care for pregnant women and to improve the quality of care overall. Keywords: Self-care, remote care, antenatal care, pregnancy
Commentary Self-care is defined by WHO as “the ability of individuals, families and communities to promote health, prevent disease, maintain health, and to cope with illness and disability with or without the support of a healthcare provider” [1]. Self-care interventions offer innovative and equitable ways to strengthen access to sexual and reproductive health services, especially in rural and low-resource settings experiencing provider shortages [2]. Self-care interventions can potentially reduce the cost of care by reducing travel to facilities and time off work. It is also likely that people and health workers will be more at ease with self-care options with the increasing availability of digital tools and technologies [3]. In 2016, WHO published 49 antenatal care (ANC) recommendations for a positive pregnancy experience [4]. In this guideline, WHO recommended a minimum of eight contacts between the pregnant woman and the health system and emphasised the importance of supportive communication and information exchange. The increased number of contacts were aimed at improving the likelihood of diagnosing asymptomatic conditions that may pose a risk to the health of the mother and the * Correspondence: [email protected] 1 Concept Foundation, Geneva, Switzerland Full list of author information is available at the end of the article
fetus. The main content of additional contacts includes checking blood pressure and urine, ensuring that the fetal heart rate is detected and that there are no obvious abnormalities. Perhaps more importantly, these added contacts allow caregivers to respond to the pregnant woman’s questions, provide counselling on healthy behaviours and discuss key postpartum issues such as breastfeeding and contraception. In 2019, WHO published the first consolidated ‘living’ guideline on self-care health interventions, which included ANC interventions for nausea and vomiting, heartburn, leg cramps and constipation [1]. Additional opportunities that self- and remote-care interventions present to pregnancy care will be further developed in the context of this ‘living’ guideline. Both self-care and remote care are feasible for pregnancy care. Several interventions can be accessed, used and administered by women themselves such as selfmonitoring of blood pressure and urine testing. Remote care uses informatio
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