Teaching Guatemalan Lay Midwives Acupressure: Outcomes and Lessons Learned.

Purpose: Lay midwives attend most births at home in Guatemala facing many challenges with limited resources. Current research demonstrates that acupressure can reduce preterm contractions and encourage post-term labor. Sharing acupressure techniques with lay midwives could improve birth outcomes in Guatemala. The purpose of this study was to deliver an educational session for lay midwives to assess their learning and satisfaction with acupressure, and its feasibility and usefulness in their work. Methods: Two acupressure protocols were designed based on the clinical expertise of University of Utah College of Nursing faculty and extant literature. Demographic data and a pretest were conducted, followed by a focus group and various educational activities. A post-test was administered, and participants were given Spanish-language, laminated Reminder Cards with acupressure point illustrations to reinforce knowledge retention as the group had a low literacy rate. This study was IRB approved. Results: Eleven lay midwives participated (all female, average age 52 with an average of 21 years of lay midwifery experience). Lay midwives lacked knowledge about acupressure before the educational session and were eager to learn. Afterward, most participants recalled six points to discourage preterm labor and six points to encourage post-term labor on a post-test, and expressed an intent to use their new acupressure knowledge with patients. Discussion: This sample of lay midwives eagerly embraced new acupressure information and demonstrated increased knowledge after this educational intervention. Next steps would be to continue to expand lay midwife knowledge and skills in response to their request for acupressure interventions for retained placenta.