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Skilled Midwives Key to Fighting Global Mother, Baby Mortality Rates
New study shows life-saving importance of skilled birth assistants and simple techniques
- The story goes like this: a young mother lies quietly in a dimly lit room having just given birth to her baby. For the next seven days she watches over the child with caution, nursing and swaddling it patiently. Fearful that the infant will not survive past a few days, she refuses to give it a name.
Unfortunately, this scenario remains the reality for many women across the globe. There are 135 million live births every year, with only 11 million benefiting from quality care – a divide not only between rich and poor but also between life and death.
On Tuesday, Save the Children launched their annual report State of The World’s Mothers 2013: Surviving the First Day. The report emphasizes the need for quality care around pregnancy, delivery and postnatal care.
“The first hours and days of a baby’s life are especially critical,” it says. “About three-quarters of all newborn deaths (over 2 million) take place within one week of births. Thirty-six percent of newborn deaths (1 million) occur on the day a child is born.”
Sometimes it is as simple as not having access to an educated midwife or community nurse. Other times it’s as complicated as having to wait for a husband’s approval in order to go to the hospital to deliver the baby.
Then there are the infections that newborns are prone to when they come into this world, and also the health of the mother during and after pregnancy.
“An empowered and educated mother is the best thing for a child,” President and CEO of Save the Children Carolyn Miles said as the report was launched at the United Nations.
The report cites three major causes of newborn mortality: severe infections, pre-term birth and complications during childbirth.
At the heart of the problem is the fact that millions of women lack access to a physician or healthcare facility.
“As we start to do more for newborns, the quality of care is also really critical, because we want babies not just to survive, but to survive without disability,” said Professor Joy Lawn, director of the MARCH Center at the London School of Hygiene and Tropical Medicine.
This means making maternal and child health a priority for government officials and community leaders. It means having conversations with husbands and fathers about the need to have a birthing plan.
“We’re not going to solve all these issues without involving and engaging men,” Miles told IPS.
“We have got to work in communities to actually engage husbands, make them part of the plan. A woman develops a plan to get to the hospital to be able to deliver; engage her husband in that plan. Make sure he’s expected to be part of the plan and has put away a little money if there’s a transportation need. He’s actually part of that.”
Losing a baby during childbirth has become commonplace in the developing world. It is understood that childbirth is a terribly difficult thing with sometimes devastating results, but still a natural order.
“There is this sense of, ‘this is just what happens’. Babies die, babies are born too early, and they’ll die. Mothers don’t name their children for seven days because so many will die,” Miles told IPS. “So it’s changing that idea that every mother and every child deserves to live through birth.”
According to the report, 800 women die during pregnancy or childbirth and 8,000 newborn babies die during their first month of life. It all seems to boil down to two essential factors: education and access.
Those few midwives or birth attendants who are available – especially in rural areas – usually lack adequate training in prenatal and postnatal care. What little education on the topic they have, they’ve learned along the way from previous childbirths, some not so successful.
Public health advocates say these providers need proper training and tools to carry out basic tasks like cleaning the umbilical cord after childbirth and teaching new mothers about infection.
This leads to access, another issue preventing pregnant women from receiving the best care during such a critical time. Rural areas are hard to reach, community workers are not paid enough to allow travel, and resources are scant.
“Part of the solution is to train more community midwives and health workers,” says Catherin Ojo, a chief nursing officer at Ahmadu Bello University Teaching Hospital in Zaria, Nigeria.