Clean birth practices

                                   The WHO six “cleans”

                               1. Clean hands of the attendant
                               2. Clean surface
                               3. Clean blade
                               4. Clean cord tie
                               5. Clean towels to dry the baby and then wrap the baby
                               6. Clean cloth to wrap the mother

I woke up this morning with the fact that we have to go back to basics in order to save maternal and newborn lives heavy on my heart. The research exists: Clean birth practices including clean birth kits reduce the number of deaths. It is hard to come by good “high quality” research because once one of these topics is addressed (for example, what is the impact on maternal infection if a clean birth surface is provided), then it quickly becomes unethical to test what happens if the clean surface is NOT provided. As a result, studies are generally “low” quality. I’ve been pondering this over the last months … how to really track the impact of little changes.

Read an excellent article this morning:

Clean birth and postnatal care practices to reduce neonatal deaths from sepsis and tetanus: a systematic review and Delphi estimation of mortality effect

Bottom line:

“Clean practices at birth and in the postnatal period could prevent many needless deaths, especially in settings with high baseline neonatal mortality and where the majority of births still take place at home, although in many facilities in low income settings, hygienic practices may also be sub optimal. The benefits of a clean birth have been recognised for centuries and if this basic and feasible action was achieved for every mother and baby of the 135 million births each year, over 100,000 lives could be saved each year “[94].

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