2023-10-18 12:57:00
Italy is not a country to be born in. The birth rate is a red alert well described by the over 141 thousand births lost from 2012 to 2022. The trend does not spare Lombardy where, compared to 10 years ago, new births are almost 25 thousand fewer. Zooming in on the upper Milanese area, however, there is a city where the cradles do not empty. “In the Obstetrics and Gynecology Department of the Legnano hospital”, leading unit of the West Milanese Asst, “the number of births has remained constant in the last 5 years. In 2022 alone there were 857, 30 more than in 2021, against a -2.3% recorded at a regional level”. The case was reported by the director of the department Guido Stevenazzi, who described to time.news Salute the model that made this countertrend possible. His watchword: “Keep the numbers constant by raising the bar of quality – he explains – by building an approach based on the personalization and humanisation of maternal care”.
Falling birth rate in Italy, the data
From 535,428 births in 2012, in Italy the number went to 393,997 in 2022 (-26.4%); in Lombardy, in the same period, it dropped from 93,284 to 68,397 (-26.7%). “It’s a great social problem and also an economic concern”, reflects Stevenazzi. The phenomenon has created “unique challenges for hospital structures – he underlines – and we have taken them up in our own small way, trying to make women live the experience of pregnancy and the puerperium in complete harmony and safety. With this awareness we have focused, as well as on clinical competence and cutting-edge technology, also on the emotional and relational sphere, with less recourse to medicalisation. The goal is represented by 438 females and 419 males who were born last year” in the only city sung, together in Rome, from Mameli’s Hymn.
What happens in the Legnano hospital
“The numbers are confirmed” even after the pandemic emergency, a particularly hot period for the Legnano hospital designated by the Region as a Covid hub for Obstetrics, the smallest in Lombardy.
Small, but prolific. “Our mothers – says Stevenazzi – are approximately 65% Italian and the remaining 35% of foreign origin. The average age is 31.6 years, 32.3 for Italians and 30.3 for foreigners, in line with national data”. Their appreciation for the Legnano department “is also reflected on social platforms and this makes us really happy”, remarks the head physician. “It is the result of teamwork involving 13 doctors, including myself, 6 nurses, 13 social-health workers and 27 midwives”. The latter with a leading role in the ‘Legnano model’.
“Our midwives – explains Stevenazzi – are present not only in the delivery room, but also inside the department and in all the clinics. With them, professional figures responsible for the well-being of women and children, the exchange of opinions and ideas is continuous.” Furthermore, in Legnano, “as part of an organization promoted by the Lombardy Region, some midwives are also specialized in personally following low-risk pregnancies. If there are patients who, due to empathy and type of approach, or perhaps due to awe towards the doctor, they prefer to be followed by the midwife, through an in-depth interview, and if they do not present risk factors, they are accompanied by the midwife for the entire gestational period up to the birth. The literature data on this mode of assistance is positive – says the expert – also in terms of patient loyalty to the department”.
Legnano midwives ‘sentinels’ of possible post-partum critical issues
Furthermore, in Legnano obstetrics and gynecology the midwives are ‘. “Also thanks to their presence in the ward – highlights the director – we try to understand before discharge which mothers could have a greater risk of depression”. If the danger of ‘baby blues’ is detected, “the psychologists of our hospital are immediately contacted, we have a dedicated one, and in particularly suspicious cases we do not discharge the patients, but keep them in the ward until we are sure that they can count on a welfare connection with the territory”.
At the moment of birth and in general during the peri-partum period, continues Stevenazzi, “even in the most difficult moments we allow the father or any figure the woman wishes to have by her side to enter the delivery room or ward”. There is great attention to combating pain, with “a birth-analgesia service available for a year 24 hours a day, including Saturdays and Sundays”, and “to accommodate as much as possible patients who express the desire for a natural birth “. A viable option “even in the case of previous caesarean sections or a baby in the breech position: thanks to a clinic specialized in the turning maneuver, in 60% of cases we are able to guarantee the mother a natural birth”. In general, “on the cesarean section front we are in the ‘green zone’, within the thresholds prescribed by the Region for good quality”.
In the path of humanization of the Legnano department, an important page was written by the Bianca Ballabio Foundation, founded in 2021 to remember a medical student from the University of Sassari who died at the age of 20 in a road accident, on the initiative of mother Michela and father Maximum. “The donation of 4 special showers for each of our delivery rooms – Stevenazzi is keen to remind us – since last year allows us to offer pregnant women the possibility of labor with natural analgesia in water, but also of music therapy and chromotherapy”.
“Another key to success is the close collaboration between different medical specialties present in our unit: gynaecologists, obstetricians, anesthetists, pediatricians-neonatologists and interns work in synergy to ensure a complete and multidisciplinary approach, providing women with 360-degree support and tailor-made”, reiterates the head physician. “The safety of mothers – he adds – is also guaranteed by an interventional radiology service that is always available, as few hospitals can ensure. And that of babies by a recently certified neonatal pathology service, under the direction of Dr. Laura Pogliani”. The ‘Legnano formula’ is completed by “linguistic mediation services for full integration”, and “continuing training and education activities for pregnant women in collaboration with local structures. Information programmes, pre-natal courses, psychological support”.
In conclusion, Stevenazzi points out “a curious fact. In recent years, at a national level, check-ups during pregnancy have increased: in approximately 92% of cases there are more than 4 obstetric visits, and in almost 77% more than 3 ultrasound scans. Expectant women show anxiety about being followed, the desire to be held in some way ‘by the hand’. Responding to this need can prove successful, people understand who is working on it and reward the commitment of reality like ours. I remember that in Italy, in 2022, 89% of births still took place in public hospitals. That must mean something.”
#cots #dont #empty