Thursday, July 17, 2008

Peru's ploy to end homebirth

Peru embraces vertical birth to save lives

Some choice quotes:

"Condori said she did not want to take any chances and that hiking through the mountains was a safer bet than having her baby at home."

"The hope of the program is to cut high rates of maternal mortality by encouraging poor, mostly indigenous Peruvian women to place themselves under the care of professionals."

There we
re some good things in the article, even if the overall tone is to emphasize that these women are dieing because they are home. Like I was happy to see this:

"Peru's health ministry has said vertical birthing positions can be healthier for women by reducing pressure on the uterus and large blood vessels that can affect the amount of oxygen going to the baby. Standing or sitting during childbirth also tends to reduce labor and delivery time, according to the health ministry, and allows the mother to watch the birth better than if she were lying down."

"The practice of women giving birth on their backs is done for the convenience of doctors, not women, say supporters of Andean birthing methods."

Peru has a recent history of trying to rid itself of traditional rural parteras. I have corresponded with a German homebirth midwife who lives in Cusco, and it is rather hostile there for midwives according to her.

This article makes me feel so frustrated. Yes, Peru's maternal mortality rate is devastatingly too high: 185 women die per 100,000 births. But, is the move to hospital or clinic births the answer?

In my opinion: NO.

Why not start a national program to educate
existing midwives in how to treat and handle shock and allow them to carry lifesaving anti-hemorrhagic medications? Why not start a national program to CREATE more midwives who will serve these women in their homes, and ensure they are adequately nourished prenatally? I have read many times that many rural Andean Peruvian women give birth with just their family present, and if there is a problem, they then send their husband out to fetch the midwife.

It has been shown again and again that it isn't the fact of being HOME that increases the maternal mortality rate. It is the undernourishment and poverty of women, and the lack of access to skilled attendants when they are need of them.

Does it really make sense to have a woman hiking 5 hours in labor to reach a clinic to birth? I will be shocked if this support of vertical birth is going to start bringing women in droves to birth in the
clinics. Women in many cases can't leave their homes, especially if they have other young children.

My family is planning a vacation to Peru in a few months, and I am hoping to meet the German midwife and talk about this topic more with her.


midwife of the plains said...

Wow. Peru. Are you working there or vacationing? The issue of supporting local midwives is so frustrating and mind boggling. I have to ask myself over and over. What is the intention here? Is the intention to create safe and healthy mamababy care? If not (and it seems like NOT), I would like for it to be. Thank you for this post. Very interesting article.


Radical Midwife said...

Just vacationing for now. I don't know if I feel safe politically to work as a midwife there. It is my husband's home country though, so a possibility in the distant future.

R&A said...

Well I guess we'll find out, when the impoverished, undernourished women get "professional care," and their mortality rates aren't helped in the least. Maybe then they will realize, this isn't about machines at all.

majikfaerie said...

Ugh. I so agree with you. Training and supporting local mws would be infinitely better than having women hiking down mountains to birth with 'professionals'.
I've been to peru about 4 years ago, and i've seen how the people are there. I think just a little education and support, especially about nutrition, would make a huge difference.

Michelle said...

Interesting! I was wondering about that article and started a thread at M&M but it hasn't had much traffic yet.

I took the article to mean women were giving birth lying down at home with midwives- and I thought, *if* they are it's because of western influence!

Thanks for giving me another perspective!

lisa.c.milton said...

I'm wondering what you learned when you visited? I completely agree with you on this. Having spent some time in Peru shadowing a local nurse midwife I've seen this first hand. I am working on writing a paper on this topic and would love any resources or extra information you may have collected. Thanks!
(Midwifery Student)