During pregnancy and the first few months of the baby’s life, parents are particularly receptive to the information these health professionals offer them. FAME (Federation of Spanish Midwifery Associations) and Fundación MAPFRE are committed to training as a way to ensure that these professionals can contribute to a reduction in child mortality due to traffic accidents.

Over 500 children die every day in traffic accidents all over the world. A figure that makes this one of the leading external causes of childhood death: 23 percent of all deaths among children aged 0 to 14, according to a report drawn up by Fundación MAPFRE in 2014. The same report confirms that this figure has declined over recent decades thanks to the widespread use of child restraint systems (CRS), although there are still fatalities associated with failing to use them: “30 percent of children aged 0-12 killed in accidents when traveling in passenger cars or vans, were not wearing any kind of safety accessory.” In other words, the message about the importance of the CRS has got through to the public, but perhaps not enough. Given this situation, there is clearly a need to turn to those in a position to improve the training and awareness of parents regarding the need to use them. For example, midwives. The idea is to turn them into broadcasters of road safety facts and knowledge. To achieve this, they require suitable training, as well as sufficient resources and the tools to go on to educate the parents. With this in mind, FAME (Federation of Spanish Midwifery Associations) and Fundación MAPFRE launched a series of classroom courses targeting the whole of this profession. At the same time, they created the online course “Babies and Children Safe in the Car” which is delivered through the UNED (National Distance Education University).

To ensure that the information reaches the parents, ever since 2016 they have distributed close to 1,500,000 copies of the guide Babies and Children Safe in the Car. The guide offers specific tips for parents in general, and pregnant women in particular, as well as recommendations about how to safely transport a child, right from birth through to the time when a seat belt can be worn. The guide also includes a section for parents of children with special needs. Its purpose is to provide a complete, practical manual, so as to have all the means at our disposal when it comes to preventing children from suffering injuries due to a failure to use, or the improper use of, child restraint systems.

Thanks to the agreements signed between FAME (Federation of Spanish Midwifery Associations) and Fundación MAPFRE, midwives have become spokespersons on road safety issues. The fact is that from their position as influencers of families and, in particular, pregnant women, they can help to reduce the numbers of children killed on our roads. One of the architects of this project is María Jesús Domínguez Simón, president of FAME (Federation of Spanish Midwifery Associations). We had a chat with her.

“During pregnancy, the midwife is in a privileged position, as a point of reference for the woman”

¿What can midwives do for the road safety of pregnant women and babies?
If you really think about it, the midwife’s role in road safety is extremely important. We work throughout the pregnancy to ensure that the expectant mother travels safely and understands its importance for her and her baby. Moreover, we create the conditions for increased awareness of the use of child restraint systems, given that, during pregnancy, the future mother and her family are highly receptive to the information they receive. And the midwife is in a privileged position, as she acts as a point of reference for the woman. We must take advantage of that moment!

Are parents aware that traffic accidents are one of the leading causes of death among unborn babies and infants?
During pregnancy, maybe not. At that time, they’re thinking about their future baby and they don’t ask themselves what they can do during pregnancy to take care of the fetus. But they do ask us a lot of questions about the child restraint systems.

What are the main doubts they have in this regard?
I’d say the choice of the seat. What kind of seat they should buy is the most frequent query they pose during the maternal education sessions. The rear-facing child safety seat is one of the most common doubts.

María Jesús Domínguez Simón, president of the Madrid Midwifery Association

What is the most “dangerous” age or period for the unborn child?
As the pregnancy progresses, seat belt usage decreases. It’s most important that the safety measures in this regard are heightened throughout the pregnancy. What’s more, we must anticipate events and offer tools to deal with what may occur during the first few weeks after birth, when the baby cries and our instinct tells us that we need to hold the child in our arms, for example.This is something we don’t consider, given that we all know the theory, but when the moment comes, we don’t know what to do.

Are the midwives trained in this kind of systems?
Increasingly, this is the case. After four years of this collaboration between FAME and Fundación MAPFRE, we’ve given over 1,800 midwives Road Safety training. Thanks to these training courses, we know what we’re talking about. In fact, they keep demanding that we repeat the courses and workshops. In Madrid, for instance, we’ve already run six editions.

Are the midwives receptive to this “new” role regarding road safety?
Without a doubt. Informing on how to best care for the newborn is oneof our core tasks, and road safety clearly forms part of this area.

What benefits do the families reap when you work with pregnant women/mothers on the importance of road safety?
Those families which are more in tune with road safety education will assimilate its importance, creating a habit that will last forever. In short, this is what health education pursues.

Would it be necessary to run specific road safety workshops for pregnant women and new parents?
That’s not necessary. They receive the training they need in maternal and parental education classes. We also use individual consultations when there is a need to reinforce some aspect.

What are the suitable restraint systems for expectant mothers and babies?
Pregnant women should be aware of how to use their seat belt correctly, the right distance from the steering wheel and the changes experienced during pregnancy that condition trips in one way or another. They also need to know which child restraint system to choose, understanding the importance of using a rear-facing child safety seat until at least the age of four, or how to make the first journey.

Indeed, how should that first journey be made?
In the seat. This seems obvious, but it isn’t. Parents must understand the importance of this first trip: knowing how to fit the device properly in the car, how tight the harness straps should be or what to do if the baby cries. One of our jobs is to prepare them for any unforeseen event.

Las matronas y su papel
en la seguridad vial infantil

This project has been ongoing since 2015, with this new task. Have you noticed the progress among parents and midwives?
In effect, we have analyzed the impact of this project by measuring the time that the midwives devoted to discussing road safety education before and after our intervention. They currently devote much more time and the contents of the maternal education classes have been standardized.

What objectives and goals have been achieved?
We’ve managed to normalize road safety issues in the consultation with a midwife. This progress has been achieved by providing midwives with the tools to work in a consistent fashion.

The project has made surprising progress since it started in 2016, hasn’t it?
Yes, indeed. We started designing and distributing the guide Babies and Children Safe in the Car through FAME’s member associations. Later, we realized that we needed to train the midwives and we designed courses and workshops for them, with the aid of midwifery associations. At the same time, they started distributing the guides with the Present Service sample packs sent to hospitals and health centers throughout Spain, as well as with the magazine Mi bebé y yo. The most recent step we’ve taken was drawing up a safety manual for expectant mothers and newborns in the first 28 days of their life. And trying to export this experience to Latin American countries