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Virtual reality training could save at risk mums and babies

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40 black women per 100,000 live births died last year in the UK from pregnancy-related complications

Scientists are working on virtual reality training in birthing scenarios to try to improve outcomes for mothers and new-born babies.

They’re specifically looking at maternal morbidity issues affecting black and Asian mothers.

Figures show black women are four times more likely to die in the UK from pregnancy-related or childbirth causes than white women, and Asian women face twice the risk.

According to current data, 40 black women per 100,000 live births died last year in the UK from pregnancy-related complications.

Oxford Medical Simulation is working on virtual reality training in a bid to eradicate the disparity that currently exists.

The obstetric scenarios cover conditions like preeclampsia and gestational hypertension, complicated by diabetes and intra-amniotic infection.

They are also looking at different scenarios for postpartum haemorrhage which is one of the most dangerous conditions facing mothers after birth.

Rebecca Wheeler, an advanced practise nurse with Oxford Medical Simulation, said maternal mortality, high blood pressure and heart disease are three health conditions that disproportionately affect ethnic minorities, lowering life expectancy by several years.

She said: “Nursing and medical students already have limited ability to access obstetrics experiences across the board, so it’s very difficult to get them in to see a normal delivery, never mind a high-risk situation.

“There is a high level of interest and demand in obstetrics, and simulation training is very time-consuming – it requires specialised mannequins, equipment, fake blood – and then you have to repeat it over and over again, until you’ve reached the entire target population. Institutions lack the resources to provide simulation experiences due to scheduling issues, time constraints and financial limitations.

“In order to improve outcomes for patients, it’s vital that both professional and student learners have access to a meaningful and engaging education. At Oxford Medical Simulation, we recognised this and wanted to bridge the gap between access to training and quality care. We have launched our virtual reality and screen-based simulation technology to train healthcare professionals, providing an invaluable solution and improving outcomes for maternity patients and their newborn babies.”

She said racial disparities in healthcare existed across the world, and maternal morbidity was much higher in some countries that it needed to be.

“There has always been a maternal mortality problem in the UK, but we’re becoming more and more aware of the impact of racial disparity and the statistics, across the board, are impossible to ignore. There is no reason for so many countries to have maternal mortality rates as high as they are. However, the sector has become mechanised and while these processes have improved some aspects of care, they are also taking providers and nurses away from patients’ bedsides.

“Black women die at a much higher rate than white women across the UK, so it’s incredibly important we start opening up those conversations. We’ve introduced a black patient in our virtual reality simulation training, in the hope we can encourage those lines of communication and address the current issues people are facing.

“In addition to an increased prevalence of conditions such as preeclampsia, obesity and high blood pressure across the entire population, racial, social and economic factors also play a large role – people who are financially disadvantaged or uninsured may have limited access to care. Additionally, we’re learning that implicit bias in healthcare has a tremendous impact on maternal and foetal outcomes.”

“There are fewer and fewer placements and hospitals are less willing to open their doors to students. When you have a real-life emergency, there isn’t enough time to train and support a student – it’s all hands-on deck.

“Fortunately, pregnancy and childbirth are usually very normal conditions, and they can be absolutely wonderful experiences. However, when things go wrong, it happens very quickly, and you need to know what to do fast.

“Being able to practise without having to participate in time-consuming simulations is essential so nurses and providers are able to engage in annual competencies and keep their skills and training up to date without having to worry about scheduling problems or resource management.

“Single player scenarios, with individual user experiences, fill part of that need, but when you’re practising in a real world you have to work with other professionals, and you have to do it well. That’s where the multiplayer dimension of the platform comes into play, so you can engage in real time communication and interaction.

“Each year, nursing, medical and hospital associations concerned with maternal health create specific initiatives to focus on, and this year, these emphasise prevention of maternal mortality by educating people on a number of really high-risk conditions. It’s a mandate – hospitals could lose their accreditation if the correct training isn’t provided.

“Our obstetric scenarios also cover preeclampsia and gestational hypertension, complicated by diabetes and intra-amniotic infection. We’re working on creating multiplayer scenarios for postpartum haemorrhage, which is among the most dangerous conditions that women may face in the postpartum period. All these conditions have been targeted by international organisations as being of utmost importance in the battle against high maternal mortality.

“What will make a difference is ensuring these efforts and training are meaningful, and this is just the beginning. Declaring that racial disparity is a public health crisis must be more than just acknowledgement to the problem. Patients need more positive experiences with childbirth and encounters with medical professionals – it’s essential they understand the needs of different ethnic groups.

“While large gaps in the healthcare system remain, there is a strong focus on medical development and training, and with the awareness of experts and physicians across the nation, reducing racial disparities appears to have taken a top spot on the public health agenda.”

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