An Everyday Miracle: Delivering Babies, Caring for Women – A Lifetimes Work
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To see women through the various stages of their lives seemed a natural progression in the provision of holistic care to them, as we moved through life together. Quite simply, an appalling number of women in the world become pregnant against their will, and practically face a death sentence when that happens. Most women in the world do not deliver in birthing units and do not have experienced personnel available to help them. Even when the personnel are available, they do not always have the necessary skills and very simple remedies that will enable them to save lives.
To try to address this, I worked with the rcog and with the Liverpool School of Tropical Medicine lstm and Professor Nynke van den Broek, to develop a three- to four-day Life-saving Skills Course for international nurses, midwives and medics. The course allows faculties of obstetricians, midwives and anaesthetists from the uk and Ireland to provide hands-on, in situ training to midwives, clinical officers and medical officers working in resource-poor countries.
Research has now shown that this type of training significantly reduces maternal loss.
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Over the years, I worked with some great characters who told me terrific stories about their working lives. Over the last forty years, Caesarean sections, pain relief, fetal viability and teenage pregnancy are just some of the areas in which attitudes have changed drastically, and such subjects continue to provoke much discussion both inside and outside the profession. Above all, this book is my tribute to the many women that I have cared for over the years.
I hope it will give people, especially men, a greater understanding of the challenges that women face and how they cope with them, and of what needs to be done to ensure that they receive the standard of care and respect that they deserve.
All the events described in this book are based on my experiences. Sometimes, insights come at the most unexpected times. Tom was an only child, something he told us he regretted to an extent. He mentioned that his mother had been very assiduous and kept little Letts diaries all her life. He had not had time to go through them yet, but the diaries were all catalogued and neatly set in rows in a wooden box in the attic. It was 16 July However, you can also use this method to work back from the date of birth to determine the date of the first day of the last period before pregnancy.
From there, you can pretty much count on the fact that conception has occurred fourteen days later. Tom passed me the diaries and I started to leaf back to that month. Tom, meanwhile, told us all a bit about his youth. His father had been in the army, doing his bit for King and country in South Africa. He had been in the Pioneer Corps and had been injured in a land mine incident while training in the country. His mother had often told Tom that she had, at one time, decided to remain childless, and that Tom had been an accident. It is generally recognised that in the uk, for example, about 40 per cent of pregnancies.
This action might not be possible to undo. Are you sure you want to continue? Upload Sign In Join. Home Books Science. Save For Later. Create a List. Read on the Scribd mobile app Download the free Scribd mobile app to read anytime, anywhere. Acknowledgements In I married the amazing and beautiful Samina who hails from Asia. Finally, in May , the clinic opened a purpose-built compound with the capacity for more patients and programs, including the bed maternal health unit. They also performed 10, antenatal screenings and 4, family planning appointments, and saw patients for post-abortion care.
One afternoon, I sat down to talk with San San Win, a year-old woman from rural Bago, an area northeast of Yangon, who occupied bed No. Win and her husband, Aung Win, sat on beds facing each other, their son and the cumbersome tank between them. San San Win has two children from a previous marriage, but Thin Tharoo is her first child with Aung Win, who is an agricultural worker in the Mae Sot area. He has a work permit, but she is undocumented. She gave birth to her first two children at home in Myanmar with a traditional birth attendant, or TBA.
Their practice is based on traditional knowledge passed down in the community and through apprenticeships, but most have not gone through formal healthcare training. Win visited the clinic for the first time when she was four months pregnant and came back every month for a follow-up. Everything seemed to be OK.
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Both she and the baby were healthy and the delivery proceeded normally. Then about two hours after she gave birth, Thin Tharoo turned blue. He was struggling to get enough oxygen. The difference between giving birth at the clinic and giving birth at home, in this case, was life-and-death. MTC had equipment and staff members trained in emergency obstetrics who could act fast and handle the crisis.
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The Mae Sot hospital, if needed, was less than five miles away. Childbirth in crisis conditions can be as dangerous as gunshots and landmines. One in five women of childbearing age in crisis situations is likely to be pregnant, according to the United Nations Population Fund. Sexual and reproductive health is a leading cause of death, disease and disability among displaced women in this age group. For women in countries affected by conflict, the estimated lifetime risk of maternal mortality is 1 in 54, compared to 1 in 76 for the developing world and 1 in 8, in industrialized countries.
The Mae Tao Clinic provides more than , consultations a year across all its departments. But even with that reach, for every patient who can make it to the clinic there are hundreds of thousands Maung would like to serve who cannot. For people in the isolated east of Myanmar, and the , internally displaced persons across the country, healthcare is largely out of reach.
Fellow refugees learned basic physiology and practiced medical skills, growing the ranks of people able to provide acute treatment and skillfully assist women in childbirth. Those evening discussions in physiology and first aid ultimately evolved into a broad training program with multiple tiers and specialities, including emergency obstetrics.
This has had an enormous impact overall on childbirth in the region. Mae Tao partners with eight ethnic health organizations in Myanmar, including Karen, Mon, and Shan groups, who send representatives to Thailand to undergo health-worker trainings every year.
The training to become a midwife takes two years, including practical experience. The midwives can then expand the network by holding their own trainings back home to educate birth attendants. More than 1, people have graduated from the trainings to date.
Naw Kyi Htoo has been a maternal and child health worker in Karen State for 30 years. She also acts as a trainer, and has come to the clinic for follow-up training every year for the past Htoo spends most of her time traveling around in mountainous backcountry.
She helps delivers between 70 and 80 babies a year, mostly home births, through a referral network. She tries to be present at as many births as possible, but it can take a full day of travel, on foot, to get to some of the villages. Others are inaccessible during the rainy season. Within five years, the military had destroyed all but one.
These groups of mobile medics ventured to dangerous areas where medical care was nonexistent, training and restocking at the clinic in Thailand every six months or so. There are still few physical clinics in eastern Myanmar, so the backpacker teams and mobile medics like Htoo are key to providing care there.
In , they targeted a population of , with no other access to medical services.