Human
Immunodeficiency Virus - Acquired Immuno-Deficiency
Syndrome (hiv/aids)
The International Confederation of
Midwives believes that midwives, who are mainly women, in their capacity as
professionals and members of communities need to be educators as well as
practitioners working to prevent the spread of HIV/AIDS and provide care and
treatment as it becomes available.
Because they are key health workers they are in a position of leadership
in making a positive contribution to preventing the spread of HIV/AIDS in the
environments in which they live and work.
It is the firm belief of the
Confederation that irrespective of any positive HIV/AIDS status, all women
should have ready access to non-discriminatory, affordable midwifery care
during pregnancy, childbirth and the puerperium and
that this care should be extended to the care of the baby in the immediate post
natal period.
The Confederation believes that all women should have the right to full
information on prevention and care of HIV/AIDS as well as on the prevention of
transmission of HIV from mother to child.
The Confederation also believes that
midwives, by maintaining updated knowledge and competencies,
1. will be
able to work with their communities to minimise the spread of HIV/AIDS by:
i) educating communities to a level of understanding as to how
the virus is acquired and spread, including transmission risks from an
HIV-positive mother to her infant, in particular at birth and during the
breastfeeding period, thus empowering them to take responsible decisions and
actions in lifestyles;
ii) providing
advice on nutrition, general hygiene and well-being ;
iii) providing health care
services and equipment;
2.
will be competent to work with medical staff, other health care workers
and communities in caring for infected individuals as better interventions
become available;
3.
will, based on their knowledge and experience, be able to work with
health care researchers in their search for information relating to HIV/AIDS.
The Confederation further believes
that midwives, because of their high risk of contracting HIV/AIDS by virtue of
the contact which they might have with body fluids particularly at the time of
birth, must have all possible means of protection available and affordable to
them.
Midwives are urged to accept their
responsibility in the field of HIV/AIDS:
i) by
maintaining updated knowledge in the field of HIV/AIDS, including developments
relating to breastfeeding and lactation, by whatever means are, and can be
made, available to them in their country
ii) by following universal precautions when handling body fluids and at other times of handling infected or potentially infected blood or blood stained products: (particularly scrupulous hand washing before and after direct contact, wearing of gloves and, at birth, wearing goggles or glasses, shoes and covering all open wounds) and by using approved solutions to clean non-disposable equipment which has become contaminated
iii) by ensuring the
correct procedures for handling items/linen soiled with body fluids for washing
or destruction
iv) by the avoidance of
needle-stick injuries and correct disposal of used injection equipment
i) by
educating all age groups within communities, with special emphasis on in-school
education, as to how the virus is acquired and spread
ii) by encouraging a
responsible approach to sexual activity both heterosexual and homosexual
iii) by discouraging the
practice of Female Genital Mutilation in countries where this is prevalent
iv) by working with families
regarding the welfare of babies who are orphaned
v) by maintaining
confidentiality and avoiding stigmatisation of the woman at all possible times
i) by ensuring that women have access to
non-discriminatory care, relevant to
meeting all their needs
ii) by providing family planning
information
iii)
by offering HIV counselling and testing or referring
for testing as is protocol locally or in country
iv)
by providing information relating to HIV/AIDS,
including developments in breastfeeding and lactation in a form which can be
understood
v) by obtaining sterile equipment to
safe-guard women from blood borne transmission during labour
vi) by working in partnership with medical
staff and women in agreeing the optimum method of birth to minimise mother-to-fetus transmission at birth
vii) by the avoidance of early rupture of
membranes, application of fetal scalp electrode and
an episiotomy during birth if at all possible
viii) by working in partnership with women to
determine the optimum method of feeding the new-born to prevent vertical
transmission, and providing the practical support for the implementation of
alternative feeding if that is the woman’s choice
ix) by the provision of counselling which is
sensitive to women and their partners
i) to ensure that specific written
guidelines and protocols are developed and implemented which cover antenatal
testing, universal precautions, conduct of normal birth, midwives professional
and legal responsibilities
ii) to ensure that appropriate training and
counselling for midwives is provided and accessible
iii) to ensure that recording and monitoring
programmes are in place and operational
iv) to ensure that appropriate counselling
and sensitive deployment of midwives who become HIV positive is in place.
1 Member associations are encouraged
to investigate, advise on sources, or obtain and disseminate amongst their
members information on the subject of HIV/AIDS.
2
Working collaboratively with their local authorities
and governments to ensure that national policy and guidelines are followed as a
means of preventing the spread of HIV/AIDS, member associations are urged to
develop written guidelines to cover incidents such as normal midwifery
procedures, the position of a midwife who tests positive for HIV, and the
optimum method of infant feeding.
- HIV/AIDS and health care personnel: policies and practices. Sixth Consultation with Leading Medical Practitioners 4 – 6 November 1997. WHO/HRB/98.3
- HIV and infant feeding: Guidelines for decision-makers.
WHO/FRH/NUT/CHD/98.1; UNAIDS/98.3; UNICEF/PD/NUT/(J)98.1
- HIV and infant feeding: A guide for health care managers and supervisors.
WHO/FRH/NUT/CHD/98.2; UNAIDS 98.4;
UNICEF/PD/NUT/(J)98.2
-
United Nations System’s Forum on Nutrition, SCN News
Number 17,
December 1998
-
Facing the challenges of HIV/AIDS/STD’s: a gender
response. KIT and
SAFAIDS financially supported by UNAIDS
Many other
earlier UNAIDS and WHO documents were also referenced
Supersedes ICM
Statement:
HIV/AIDS 93/4
Adopted by the
International Confederation of Midwives Council, Manila, May 1999.
Date for
review: 2005