Toughest Place to be a MW

Bournefree

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Hi ladies,

I was just wondering if any of you had had a chance to watch the following BBC documentary on a UK MW who worked in Liberia for 2 weeks?

I found it really thought provoking. So for anyone that hasn't seen it here is a link

https://www.bbc.co.uk/iplayer/episode/b00z5868/Toughest_place_to_be_a..._Midwife/

XxX
 
i watched it, i found it quite amazing especially the bit where they were giving a talk to all the ladies in the community who acted as midwives and were told to carry the patient to the hospital in the event of an emergency you just cant imagine it can you?!

Some of the statistics were pretty shocking as well
 
I managed to watch it in bits over the course of this morning. It was really interesting. I would have liked to have seen the village MWs in action :)
 
i saw the start...to be honest I'm kind of glad I didnt watch any more I had a bit of a blub as it was.

So different to what we expect as normal here.
 
As the UK midwife said also I'm surprised it was so medicalised over there, I thought it was only the western world who didnt believe so much in natural childbirth. I'm quite dissapointed as I've been learning in hypnobirthing that other cultures have natural calm birth, this was anything but! I need to go and read some positive birth stories asap!
 
I watched it and don't think it was that medicalised for the simple reason that 63% (I think that's the right figure) are home births. Those who end up in hospital are likely to be seriously, seriously ill. I too would've loved to have seen one/some of the home births with the community birth attendants.

I personally felt so angry about the woman who died after the failed abortion. That really all she needed was antibiotics and didn't get them for days and then it was too late. This is my GBS thing, but we're looking at a neonatal mortality rate of 1/10000 and everyone is fighting to get the antibiotics yet there are women dying in less developed countries who could be saved with something as simple as antibiotics. :growlmad: I said this in a thread in general chatter but I wish I could choose to send the antibiotics over there instead.

The maternal mortality rate was 1/12. :cry: I missed the stillbirth statistic.

I was already aware how bad it is in other countries so it didn't exactly surprise but it was still sad and shocking to see. I was not surprised at the issues with with hospital facilities and when they mentioned the high turnover of midwives it's not surprising if there isn't a great skillbase. I did wonder about all the births on backs. Totally speculative of course but it made me wonder if perhaps that's done to emulate the West (particularly the States) in the misguided idea that it must be good practice and is one which can be easily implemented.

The English MW said about not being able nto make sweeping changes which of course is true but some of their practices (the ones not particularly resource dependent) struck as being a sign of the MWs simply not having training and not having access to current obstetric research and MW practice. A programme to better distribute current research would be valuable I think. But then we could argue the same here! :winkwink:

Sorry for the long post, I found it a thought-provoking doc!
 
not sure about the stillbirth figure but it said 1 in 4 would either die during just after or in the first 24hrs
 
I think it's quite a stereotypical view of westerners to think all African women are squatting to give birth in villages then off to work with the baby in a wrap....just shows how little we understand about the huge differences in the countries in this vast continent.
 
I also become very excited when they went to see the community Mws.. But was disappointed that we didn’t get to see them in action.

I had a few tears too Chuck! But there isn’t too much at the moment that isn’t setting me off! (I had a tear in my eye watching an ad the other day, and almost had a full on breakdown because we had run out of teabags! Hahaha! - silly hormones!

PB, I agree with so much of what you have said! I refrained from giving my thoughts in the OP, as I wanted to see if it had the same effect with anyone else.

I was also surprised that they were trying to emulate “western” practices.. But “western” from 30-40 years ago. I do hope they don’t take as long as us to catch up. (as we are not even there yet!)

What struck me the most was the UK Mws final thoughts on her patients that are so demanding and (dare I say it) ungrateful of her skills, the facilities and medicines that are available to them - really put things into perspective for me. As I do believe these facilities should be used more by women that NEED them.. And I’m very grateful they are available.
Also, how becoming a MW or birth attendant in any culture is a calling.. I’m in awe of the huge strengths these people have, and how very important they are to our society and I never want to see us loose MW lead care.
XxX
 
MM I agree. I do wonder (says she taking an unusual opposite side from normal) how much of the homebirthing movement is moving too far. I mean in teh sense of romanticising natural birth to the extent that it closes it's eyes against the very high level of maternal and perinatal mortality experienced in countries where maternity standards are low. There has to be a good balance. I would love to find figures that can compare birthing in different countries that fully balances for the different antenatal care factors and simple interventions like antibiotics.

Not sure if I'm wording this very well, but I mean in this case the maternal mortality was 1/12 but we saw women were dying from botched home abortions (with who knows what herbal remedy) who probably only needed antibiotics. Then there were the stillbirths early in pregnancy - what were the cauases? There was no post-mortem done. If it could be possible to tease apart all these factors and get a true sense of the proportion of birth that truly does require intervention then set that as a target across the world, downgrading the level of intervention in the West, upgrading the care in developing countries.

I have to say that for my part I don't think I've ever had an idea of African women squatting out their babies in a romantic way. I have always had a keen awareness of the level of maternal mortality in other parts of the world. BUT, as a species we have existed a long time so the majority of women MUST be able to do it naturally on most occasions. It's all about balance.
 
There's no doubt about it (IMHO) that one of the reasons home birth in developed countries IS safe is because we have the luxury of all the things they dont have in hospital births in places like Liberia. Trained MWs attending us at home with skills, drugs, sterile equipment etc....all things they were lacking in at the hospital, never mind out in the far flung villages. We have the back up of hospitals just a short (in most cases) car or ambulance ride away over well maintained (in most cases!) roads - no cars and ambulances kicking about in the villages there. Those village MWs were talking about husbands putting bleeding wives in hammocks and carrying them to the hospitals or the MWs using their clothing to carry them.

I dont think we can compare their situation to ours at all. Home birth here is safe here partly because we have the luxury of back up and hospital birth here and there are two entirely different things altogether.
 
The person who was looking for postive birth exp there is a great hypnobirthing one in a current baby magazine (one with the free changing mat in gold with a black pattern on sorry can't remember the name of the mag!) It caught my eye as my friends a hypnobirthing teacher and I always wanted to get round to having classes (I did read the book my friend gave me sadly she doesn't live near enough to do much more than send me the book!). When reading it - and having seen the photos and girls name in the article I realised she was in the year above me at school! her birth experience with hypnobirthing was great. I know lots of positive hypnobirthing and normal birth stories, its just you never hear about/remember those ones its always the horror stories that get retold and you remember.
 
People might be interested in this:
https://en.wikipedia.org/wiki/List_of_countries_by_infant_mortality_rate
It's the infant mortality rates from data from 2006 and 2009 (two different systems).
 

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