International

Midwife Robin Lim honored with 2011 CNN Hero Award

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I hadn’t followed this competition, but was excited to learn that the winner of this award, which comes with $300,000 for her cause.

About Robin:

Robin Lim, an American woman who has helped thousands of poor Indonesian women have a healthy pregnancy and birth, was named the 2011 CNN Hero of the Year on Sunday night.

Through her Yayasan Bumi Sehat health clinics, “Mother Robin,” or “Ibu Robin” as she is called by the locals, offers free prenatal care, birthing services and medical aid in Indonesia, where many families cannot afford care.

After reading about Robin and her work, I realized that her clinic sounded familiar. They are listed on my Volunteer Doula Program page! A friend of the clinics posted in comments a few years ago about their work, suggesting I add them to my list.

So glad to see their impact is being honored, and on such a mainstream platform. It’s also lovely to see a birth activist and woman of color honored for her work.

Learn more about her clinic here. They even have a birth doula workshop for interested doulas in Indonesia!

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Giving women what they want in Peru

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The New York Times last week had an article about a clinic in rural Peru that was able to draw more women in by using traditional childbirth practices.

When the women were asked why they didn’t want to give birth at the local clinic, they explained what all of us birth activists know well: they didn’t want to give birth alone, on a table, with providers who didn’t speak their language.

They started by asking people in the community about traditional ways of giving birth, and about what the clinic was doing wrong. They got an earful. Workers at the clinic did not speak the local language, Quechua. They treated patients brusquely, and barred husbands and other relatives from the delivery room. They forced women to wear hospital gowns instead of their own clothes, and made them give birth lying on a table instead of squatting. They threw away the placenta instead of giving it to the family to bury in a warm place.

We know these things. The women is this community were lucky, because the providers had to change their habits to meet their desires–because the women just weren’t coming to their clinic.

Working with local people, members of a nongovernmental group, Health Unlimited, changed delivery services at a clinic in the Santillana district. They made sure Quechua was spoken, let relatives stay and help, set up delivery rooms so that women could squat and made other changes based on local traditions.

By 2007, 83 percent of births were taking place at the clinic. In a report in this month’s Bulletin of the World Health Organization, the authors say that the project in Ayacucho shows that indigenous women with little formal education want professional help giving birth, and will use it if they are treated with respect at clinics.

Why are we building clinics and funding initiatives that have women’s desires and needs as an afterthought? Maybe stories like these will start to change the paradigm, cause the current model really sucks.

h/t to Maria Elena for the link

Birth of a Surgeon, tonight on PBS

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A PBS series tonight chronicles the story of Mozambique, where the maternal mortality rates had reached such crisis levels that they decided to train midwives to do obstetric surgery.

Sub-Saharan Africa is the world’s deadliest place to give birth. Each year over a quarter of a million women die in childbirth in the region. But Mozambique is combating high maternal death rates by implementing unconventional programs.

I have only seen the preview, which you can also watch here. Despite the rather dramatic tone (why do they have to make childbirth seem so scary?) I like the sound of the show.

Midwives often take the blame for high maternal mortality (and infant mortality) in developing countries. They are demonized when governments (both local and international) step in and build hospitals and try to “modernize” maternity care. The midwives are portrayed as backwards, uneducated and elderly. Rather than work with midwives, often this process is rather imposing, attempting to force all women to give birth in the hospitals they build with doctors instead of midwives.

There are many problems with this approach, as transportation to the hospitals built in primarily urban centers in a challenge. Additionally many of these hospitals don’t even have the resources they need (doctors, medicines, equipment) and are not providing much better care for all women than the midwives.

Much of my opinion comes from some time spent in Ecuador, both working at the public maternity ward and talking to midwives in different parts of the country.

So approaches like training midwives to do some emergency surgeries, in addition to other basic skills (like when to take a woman to a hospital) seem like a good solution to me. In the US, midwifery care remains at odds with the ob/gyn practice, I think that’s mostly a business concern. There is no reason why other countries can’t adopt a diverse a multi-tiered system. I know of another program called Nueve Lunas (nine moons) in Mexico that provides additional education for rural indigenous midwives. (Note, the link for that school is in Spanish)

The show premieres Tuesday July 15th on PBS.