Great great overview of birth in Laos. “Cultural Beliefs and Traditional Rituals About Child Birth Practices in Laos.” Just chock a block about the hows and whys of birth practices in a country with very high rates of maternal (MMR) and infant deaths (IMR).
Reccommendation for NGOs:
Provide safe delivery kits for trained TBAs and strengthen the capacity of health care providers working in the safe motherhood programs.
I love this quote: “Childbirth in Laos is still a natural event’. This despite the real risk of death. Many of the factors that prevent pregnant women from birthing with an attendant are completely understandable. Yet, something must be done to reduce the MMR which has been reported to be as high as 470/100,000. The MGD was 75/100,000 by 2015. So that’s no happening. What accounts for this?
Little prenatal care: 28.5% according to the above article
Delivery without a skilled attendant: 85%
Factors in getting help:
Delay in mother making the decision
Delay in transportation
Factors preventing women from birthing in a facility:
1. Ease
2. Family support
3. Well-known
4. Expense
5. Transport/Access for Rural: Roads, etc…
6. Hospital Practices: Birthing position, Episiotomy, Frequent Vaginal Exam, No family around, No female birth attendant, unkind treatment
7. Rituals: hot bed, baths
8. Medical personell don’t encourage birthing at facility
Factors encouraging women to birth at a facility:
1. Skilled medical staff
2. Complications better dealt with
Reccomendations
For Government and Community Members
1. Empower women to make decisions on how to take care of themselves during ANC, delivery and PNC as well as a safe place of delivery.
2. …One of the ways is by integrating male involvement into safe motherhood programs (during pregnancy, delivery and postpartum practices) as well as advocating overall reproductive and sexual health and rights. Men do seem to be very much involved in both decision-making and assisting in child birth.
Health Care Providers
3. With an understanding of the cultural beliefs and practices of women from Laos, health care providers can develop maternal education that is culturally specific…
4. The provision of mobile maternity services might be an alternative solution for unplanned home delivery due to lack of transport and precipitate delivery.
5. Establish a skilled workforce with the capability and capacity to reduce maternal and newborn mortality and morbidity (i.e. adequate numbers of competent skilled birth attendants), including developing a cadres of midwives (rural and community midwives).
6. Emergency obstetric care screenings for women who are at risks and refer them to the hospitals on time.
7. Adopt cultural sensitive programs on ANC, child birth and PNC. For example, attending ANC will not be in opposition but a combination of the cultural/habitual practices for pregnant women and their family. The involvement of the husband and family members…
8. ..recommendation to train health care providers at the grass root level and provide health facilities reaching underserved women in their community.
Ministry of Health
9. Advocate the safe motherhood policy nationwide.
10. The midwifery curriculum should be revised by taking into account the positive aspect of cultural child birth practices.
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