How can we reconcile medical safety with a sense of calm and agency for the birthing woman? Contemporary obstetrics faces a challenge that is not only about technology, but above all about the organization of care and the relationship with the patient. In the latest article in the “12th at 12” series, Monika Portacha – clinical midwife and coordinator of the Childbirth Education School at the Institute of Mother and Child – discusses which innovations truly make sense and what is most lacking in the system.
From the perspective of working both in a hospital ward and in a childbirth education school, it is increasingly clear that the development of perinatal care is not solely about implementing new technologies. What matters most is creating conditions in which knowledge, experience, and available tools can be fully utilized – for the benefit of the woman, the baby, and the medical team.
Modern obstetrics today is not only about procedures, but above all about the ability to build a balance between safety and a sense of being cared for. In this context, the question arises: which innovations truly make sense?
Innovations that genuinely support care
The most promising innovations are those that relieve staff of routine tasks while increasing control and communication.
As a clinical midwife and coordinator of a childbirth education school, I can clearly see that the greatest challenge of contemporary obstetrics is reconciling two needs:
• ensuring maximum medical safety, and
• creating conditions in which the woman feels calm, supported, and treated as an active participant.
Innovation can meaningfully help achieve both goals – provided it supports the staff rather than replacing the relationship with the patient.
First and foremost, modern systems for monitoring the mother and child hold enormous potential. Wireless devices allow continuous observation of the fetus and the progress of labor, while giving the woman freedom of movement, which is crucial for comfort and the physiology of birth. Additionally, data‑driven solutions can detect concerning signals more quickly, increasing safety and reducing the need for constant manual supervision by staff.
Another important area is the automation of medical documentation. In clinical practice, documentation consumes a vast amount of midwives’ time. Introducing voice‑based systems and intelligent forms would reduce bureaucracy and allow more focus on what matters most – being present with the laboring woman.
The importance of good communication cannot be overlooked either. Simple solutions, such as quick‑contact systems for patients or clear organization of workflow in the ward, significantly reduce feelings of confusion and anxiety in birthing women while streamlining team operations.
From the perspective of a childbirth education school, I also see great value in technology‑supported education. Access to reliable materials, apps, or online consultations means that women arrive at the ward better prepared, more aware, and calmer. This directly affects the course of labor and reduces the workload for staff.
To summarize, the most essential innovations are those that take technical and administrative tasks off the staff while strengthening safety and the sense of control for the patient. Technology should support the midwife – not replace her – because at the heart of care remain relationship, presence, and attentiveness toward the birthing woman.
The System’s Biggest Gaps: Time, Consistency, Organization
From the perspective of a clinical midwife working at the Institute of Mother and Child in Warsaw and as a coordinator of a childbirth education school, I can see that today the biggest challenge is not a lack of knowledge or modern solutions, but rather the conditions that allow these to be fully applied in practice. The key deficit remains time and consequently, staffing resources. The ability to stay with the patient, observe calmly, talk, and provide support is the foundation of good care. Without this, even the best procedures or technologies cannot fully serve their purpose.
At the same time, there is a very clear need for greater consistency and predictability of care. A woman arriving at the hospital should feel that regardless of the shift or team on duty, she will receive the same standard of procedures, communication, and support. In such an important moment, stability and clearly defined rules have a tremendous impact on her sense of safety.
Another crucial area for improvement is strengthening continuity and holistic care for the mother and newborn. In practice, this care is provided by a therapeutic team composed of various specialists collaborating and complementing each other’s competencies. Such an approach supports a coherent response to the needs of the woman and her baby – especially in the first hours and days after birth – and promotes high quality and safety of the services provided.
From my experience, I can also see that the postpartum period still receives insufficient attention. This is a time of intense physical and emotional changes, when women particularly need support – both in terms of breastfeeding and adjusting to their new role. Strengthening care during this stage can significantly improve the wellbeing of the entire family.
Equally important is the organization of work and communication – both in interactions with the patient and within the medical team. Clear information flow and reducing administrative burdens allow staff to focus on what matters most: clinical and emotional care.
From the childbirth education school perspective, I also observe how much of a difference good preparation for childbirth and parenthood makes. A more aware and calmer patient not only feels more comfortable herself, but also cooperates better with the staff and experiences a more physiological labor process.
To sum up, in order to improve care for mothers and newborns, we primarily need time, greater consistency of actions, and better system organization. These elements enable us to fully utilize knowledge, experience, and available tools – for the benefit of women, their babies, and the entire medical team.
What Can We Learn From Other Countries?
In recent years, we have observed a very clear global trend: moving away from a highly medicalized model in favor of more personalized care based on relationships and the physiology of birth. I believe that in Poland we have tremendous potential to draw from these experiences.
First and foremost, it is worth developing the midwife‑led continuity of care model. In many countries – such as the United Kingdom or Scandinavian nations – a woman is supported throughout pregnancy, birth, and the postpartum period by one midwife or a small team. This approach builds a sense of safety and trust, and research shows it is associated with fewer medical interventions and better health outcomes.
Another very important direction is the growth of birth centers or midwife‑led units, which operate alongside hospitals or as independent settings for low‑risk pregnancies. They combine the safety of a medical system with a more “home‑like” birthing environment, which supports physiology and the mother’s wellbeing. In Poland, such solutions are only beginning to develop, but they are definitely worth strengthening.
A further element is transforming the birth environment itself. In many countries, birthing rooms resemble a home‑like space rather than a surgical suite – allowing free movement, access to water, birthing balls, birthing tubs, and the continuous presence of a companion. These are not “extras” but elements that genuinely support the course of labor.
Equally inspiring are models of maternity care focused on relationship and communication. Increasingly, emphasis is placed on respectful maternity care – care in which the woman is a partner in decision‑making, has access to information, and receives emotional support. This is something we can implement without major financial investment, yet it has a profound impact on the birth experience.
From the perspective of childbirth education, I see great potential in expanding the role of childbirth classes. Worldwide, prenatal education increasingly includes not only birth preparation, but also psychological support, working with fear, preparing the partner, and real‑life decision‑making scenarios. Doulas and continuous support persons are also more often included – and research shows they increase women’s satisfaction and reduce the number of interventions.
To sum up: it is not about copying solutions one‑to‑one, but about changing the philosophy – from a system focused mainly on procedures to one that sees the woman, her needs, and her experience. Poland has highly educated midwives and growing social awareness; now we need conditions that allow this potential to be fully realized.
Innovations Worth Implementing Today
If I were to point to innovations truly worth adopting in obstetric care, I would choose those that genuinely support both women and medical staff – without taking away the human dimension.
First, I see enormous potential in telecare and remote monitoring of pregnant women. Online consultations, quick access to a midwife, or the ability to monitor basic parameters (e.g., blood pressure, fetal movements) give women a greater sense of safety, especially between visits. They also allow earlier detection of concerning signs and help reduce unnecessary hospitalizations.
Another important innovation is educational apps for pregnant women and new mothers. Well‑designed tools can guide a patient step by step through pregnancy, birth, and postpartum, answering common questions and dispelling doubts. However, it is crucial that they are based on credible medical knowledge and co‑created by specialists.
I also see great value in using modern technologies in prenatal education – for example, simulations or elements of virtual reality. These tools help women better prepare for birth, familiarize themselves with the unknown, and reduce anxiety.
We should not overlook organizational innovations, such as real‑time digital medical documentation accessible to the entire care team. This improves communication, shortens response times, and allows staff to focus more on the patient than on paperwork.
But the most important thing is that every innovation should be a tool, not a goal in itself. Technology should support the relationship with the woman, not replace it. In obstetrics, the most important elements remain attentiveness, empathy, and experience – and good innovations simply help us use them even more effectively.
Summary
Modern obstetrics stands at the intersection of two worlds: rapidly evolving technology and the unchanging human need for closeness, safety, and trust. While innovations can significantly reduce staff burden and improve the quality of care, they will never replace what matters most in this profession – presence and relationship with the woman.
The greatest challenge, therefore, is not the lack of tools, but the need to create a system that allows these tools to be used wisely. More time, better organization, consistency of care, and investment in education – these are the foundations on which we can build obstetrics that is both modern and profoundly human.
Monika Portacha, MBA – a specialist in gynecological and obstetric nursing as well as community and family nursing. She has been associated with the Institute of Mother and Child in Warsaw for over 20 years, where she works as a clinical midwife, lecturer, and coordinator of the Childbirth Education School.
She holds numerous specialist qualifications, including perinatal education, wound care, prescribing medications, and cardiopulmonary resuscitation for adults and newborns.
She is actively involved in educating women during pregnancy and the postpartum period, as well as an author and co-author of publications and a speaker at scientific conferences. She participates in projects aimed at improving the quality of perinatal care. She is also the Chair of the National Trade Union of Nurses and Midwives at the Institute of Mother and Child.