Abdominal palpation—a core skill

My mind starts to wander to the days spent training and the basic midwifery skills taught to the midwives in the health centres. The two health centres I taught at were in remote ‘kebeles’ (villages) in the Dilla Zuria region of Ethiopia.

During one meeting at a health centre, the health officer and midwives had asked for an ultrasound machine so they could better identify the gestation of pregnancies as most of the mothers do not know their last menstrual period date. To me, this seemed a strange request given that the region, as with much of Ethiopia, does not have the infrastructure to run such machines, neither do they have the training available in these remote areas to learn the skills for ultrasonography.

Instead, we taught them about the importance of basic midwifery skills, such as abdominal palpation and measuring symphysis fundal height as a guide to estimating gestational age and measuring the growth of the unborn infant. We stressed how ultrasound alone, particularly when used on very malnourished mothers, would not necessarily be an accurate way to estimate gestation.