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  1. Salam alaikum,

    Thank you for sharing your insights into this matter. I think, however, a key piece not sited is the lack of proper nutrition and clean water that is more a culprit than the lack of over-medicalised approaches to childbirth. I agree, education is key. This starts with nutrition and learning to work with our bodies in labor and birth. Over 80% of births should not need any medical intervention at all. Absolutely, access to quality prenatal care as well as well-trained birth attendants are needed. However, be careful what that looks like. A maternity model like that of the medically dominating obstetric practices of the United States is NOT what’s needed at all. In fact a more local, midwife based model, like New Zealand, is a better, cheaper, more healthy approach for all women in all countries around the world, rich or poor. Be careful what you work for, if it’s a medically dominant model, I’d have to disagree more than agree with the efforts.

    Best regards,

    Aisha

    Please read this very important article on the topic http://www.drmomma.org/2009/08/fish-cant-see-water-need-to-humanize.html

    • Salam Aisha,

      You’re absolutely right – proper nutrition & access to basic things like clean water can make a massive difference in terms of ensuring a healthy pregnancy. The article you indicated makes a very important point in emphasising the importance of midwives.Obviously in developing contexts, traditional birth attendants (TBAs) often take the place of midwives, and one of the key things we want to bring to the fore is the importance of training these TBAs to ensure a clean environment during childbirth – e.g. clean hands, gloves, using sterile scissors/knife to cut the placenta, etc – and also to know when medical help is needed! It’s also true that properly trained TBAs should be able to administer the right interventions to prevent/deal with several of the main causes of maternal deaths, such as sepsis (from unsterilised equipment!) and haemorrhaging, but sometimes medical intervention is absolutely needed. For example, a woman who is bleeding severly may well need a blood transfusion. And in cases of obstructed labour, if there is no option for a caesarean section, there is a huge risk of the baby dying and the mother suffering long term physical damage, such as a fistula. So, while I agree that the answer isn’t always medical intervention in a hospital, the right medical intervention at the right time does save lives. Having said that though – I’m certain that training birth attendants within communities will do a lot more to save lives than just building clinics, especially in places without the transport infrastructure to enable people to access those clinics! As part of the At Our Mothers’ Feet campaign, we’ll be working with our partners Ammalife to help charities working on maternal health to put money into effective, sustainable methods of reducing maternal mortality – including putting money into educating girls and communities, training birth attendants, and providing quality pre and post natal care to all women.

      Shabana

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