Safe child birth as a women’s rights issue

Every year, 303,000 women around the world die from pregnancy and childbirth related complications. That is one woman every two minutes. On average, each of those women leaves behind four orphaned children. 98% of those deaths are preventable.

So says Every Mother Counts, an international NGO dedicated to addressing the barriers to maternal health around the world.

Every Mother Counts provides grants to projects that support maternal health in parts of the U.S. as well as in Latin America, Africa, India, Indonesia, Syria and Nepal.

It has funded a number of documentary films about pregnancy and childbirth, one of which I had the opportunity to see during San Miguel’s Women’s Month activities.

Guatemalan initiative

Con Madre, the term used in Latin America for midwife, is a 17-minute documentary about a new program in Guatemala to pair trained midwives with traditional midwives in Indigenous communities throughout the country. Guatemala has one of the highest infant and maternal mortality rates in Central America, with Indigenous women at highest risk.

There are a number of reasons for this high risk in Indigenous communities: distance to health care facilities from remote communities with no reliable transportation, lack of trained health care providers, racism, language barriers and conflict between traditional medicines and beliefs and hospital-based medical practices to name a few.

Whatever the reasons, the rate of day of birth infant mortality in Guatemala is 15/1,000 live births, the rate of infant mortality in the first month of life is 17.5/1,000 live births and the death rate for babies in the first year is 24.53/1,000 live births.

Canada’s numbers are nothing to brag about

To put these numbers in context, I did some research about infant mortality rates in Canada. Admittedly, comparing these statistics is a bit like comparing apples and oranges, because every study seems to measure slightly different things: some track day of birth death rates, others look at deaths in the first 28 days, others at deaths in the first year of life and still others look at maternal mortality.

In Canada, the national average of day of birth deaths is 2.4 for every 1,000 births. This is the second highest rate of first day infant mortality in the industrialized world, with the United States ranking highest.

Rates in the North are much higher. In Nunavut, for example, the day of birth infant mortality rate is 10.7/1,000 live births, and infants are more than four times more likely to die within the first year than elsewhere in the country: 21.4/1,000 live births compared to the national average of 4.8/1,000 live births.

The reasons for higher rates in northern and Indigenous communities are similar to those in Guatemala: long distances to health centres, a lack of transportation, cultural and linguistic barriers, fear, racism and conflicts between traditional and hospital practices and medicines.

Role of midwives

A 2914 report from the World Health Organization concludes that properly trained midwives lead to a reduction in both maternal and infant mortality.

In the Guatemalan project, women study for three years at Corazon del Agua, the country’s first midwifery school, doing placements with traditional midwives in rural Indigenous communities. The first class graduated last year, and graduates are now in the process of becoming licensed.

As the midwives work together, there is a two-way learning process: for example, the traditional midwives learn skills in identifying high risk situations while the trained midwives learn about traditional practices such as the post-birth herb sauna. When a woman needs to be transported to a health centre, both midwives accompany her to help overcome the barriers that have existed in the past. The presence of the traditional midwife assists the trained midwife to be accepted by the community.

Midwives play an important role in Canada’s north and Indigenous communities as well. The National Aboriginal Council of Midwives notes that there are 65 Indigenous midwives in Canada and 13 practices focused on serving First Nation, Inuit and Metis women. The rate of women remaining in their home community to give birth is rising. 

Taking back the power

There was a time not that long ago when the medical industry took control of child birth away from women. However, most privileged women in Canada have regained control over how their babies are born and can choose from a vast array of possibilities: home or hospital birth; midwife, obstetrician or both; doula or no; medicated or unmedicated delivery; even caesarian sections have become a matter of choice.

Those choices are not available to all women in Canada or to women in many other parts of the world, with the result that millions of women give birth in poor conditions that are imposed on them, leading to both maternal and infant mortality rates that are far too high.

We must never forget that our work for reproductive choice includes the right of all women to safe child birth options and the right to choose how they want to give birth.

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