Tag Archives: Millenium Development Goal 5

Keeping Childbirth Safe–No Matter Where it Takes Place

The world finally gets it (OK, some parts of the world). Childbirth does not have to be as dangerous as it is for many women and fetuses in developing countries.  For that matter, it does not have to be dangerous for the vast majority of women in developed countries, either, but that is a whole other ball of wax (in short, think: high rates of medical intervention in low-risk women have the propensity to create more problems that require fixing, than they necessarily do solve or prevent potential problems).

Here is yet another example of a relatively simple technology with a focus on reducing perinatal maternal mortality, as presented at the American College of Nurse Midwives‘ annual convention.  The device?  A strap-on belly with uterus, baby and blood contained within.  The goal?  To get as many birth attendants around the world–especially in areas like Afghanistan, the Central African Republic and rural India– trained with basic life-saving knowledge of how to catch a baby (or help to deliver a malpositioned fetus) and intervene when postpartum hemorrhage is occurring.  Truthfully, most of the life-threatening scenarios surrounding childbirth can be handled successfully, as long as the knowledge of how to handle those scenarios is there, and well practiced.

As described in this article, “Using both hands, the teacher wearing the device can move the baby through the birth canal, which is formed from a flexible plastic frame. Simulated blood flows out of the vagina, controlled by a thumb-operated roller valve. To simulate the contraction of the uterus after delivery, the teacher squeezes air from a large bladder into a smaller one while pulling the latter lower in the pelvis. She can tap on a piece of hard plastic inside the mannequin to create a heartbeat, varying the rate and loudness to simulate fetal distress. In all cases, the sense of reality is heightened because the equipment is connected to and manipulated by a human being.”

The “Mama Natalie” simulator can even replicate a retained placenta fragment–the primary cause of third stage and postpartum hemorrhage.  When would-be birth attendants know how to recognize this condition, they can also learn how to remedy it (by manually removing the left-over piece of placenta that is stuck to the internal uterine wall, thus allowing continued bleeding).  In extremely rural areas or home birth scenarios where high-tech intervention is miles away, the performance of this relatively simple procedure, and appropriate follow-up techniques and care, can be a matter of life and death.

Kudos to Laerdal Medical for creating this device, making it available to poor countries at cost ($100/each), and adding to the overall trudge toward the Millennium Development Goal 5 which “seeks to cut the 1990 maternal mortality ratio of 320 deaths per 100,000 births by 75 percent.”

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