Midwives' Use of Life-Saving Drugs Policy

To enhance midwives' capacity to effectively respond to pregnancy-related emergencies and reduce maternal and neonatal morbidity and mortality through administration of life-saving drugs.

Emphasis on planned pregnancies and safe deliveries.
Employ gender- and culture-sensitive services.
Utilize a three-pronged approach: skilled birth attendance with continuum of care, emergency obstetric and newborn care access, universal family planning and reproductive health services.
Encourage facility-based deliveries.
Employ system-wide and rights-based approaches.

BEmONC: Basic Emergency Obstetric and Neonatal Care.
E/EmONC: Essential and Emergency Obstetric and Neonatal Care.
ENC protocol: Essential Newborn Care protocol.
Midwife: Registered and licensed persons duly qualified in midwifery.
Life-Saving Drugs: Medications to prevent/manage pregnancy complications e.g., Magnesium Sulphate, Oxytocin, Steroids, Antibiotics.
Emergency Conditions:
- Pre-eclampsia: Hypertension and proteinuria after 20th week gestation.
- Eclampsia: Convulsions and coma in pregnant/newly delivered women.
- Post-partum hemorrhage: >500ml blood loss after delivery.
- Premature labor: Active uterine contractions before 37 weeks.
- Infections.

Applies to all licensed midwives providing skilled care.
Targets those seeking PhilHealth MCP and NCP accreditations.
Includes entire DOH hierarchy, LGUs, and partners implementing maternal-neonatal care strategies.

Midwives authorized under additional functions (beyond Midwifery Act) to administer life-saving drugs during emergencies when no physician is available.
Prerequisite: Appropriate training and certification.

Midwives must undergo two-part on-the-job training: didactic and practicum using approved modules.
Post-training evaluation includes written exam and practical skill application; passing required before practicum.
Certification issued upon satisfactory practicum within six months.
Supervision mandated by local health authorities with technical guidance from professional societies (POGS, PSNbM, PPS).
Legal assistance granted for midwives performing authorized duties.
Clinical protocols dictate use of specific drugs:
- Magnesium sulphate for eclampsia prevention/management.
- Oxytocin for active management of third stage labor and postpartum hemorrhage.
- Steroids for preterm labor.
- Antibiotics for infections.

POGS: Conduct training, issue proficiency certificates, conduct monitoring, participate in maternal and perinatal death reviews.
PSNbM/PPS/PAPI: Coordinate in training, supervision, and death reviews focusing on newborn care.
Midwives Associations: Maintain member rosters, represent in mortality reviews, monitor adherence to standards.
LGUs: Ensure licensed midwives, support training, ensure adequate supplies and facility readiness, enable accessibility for training and reviews, manage enrollment and PhilHealth accreditation, establish referral systems.
DOH Offices:
- Disease Prevention and Control: Provide technical assistance, ensure protocol compliance.
- Human Resource Development: Support training and education.
- International Health Cooperation: Coordinate technical and financial support from partners.
- Centers for Health Development: Monitor and evaluate local implementation.
- Retained hospitals: Serve as training venues and clinical access points.
Development partners: Provide technical and financial support for implementation.

Monthly quality assurance and clinical audits by DOH CHDs and retained hospitals.
Progress reports submitted to DOH Secretary.
Annual review with stakeholders on implementation progress.