Wednesday, December 08, 2010

Birth Around the World: Training Medics in Burma

One of the midwife blogs I follow is Missionary Midwife Mama. She lives in Thailand and is a mother of four. She occasionally travels to other parts of the world doing midwifery training & clinicals. She recently came back from training medics in Burma. Here is her account:
I was able to teach for about 4 days. We started out by taking a survey of all the local birth practices and labeled them as "helpful" "harmless" or "harmful." I learned so much about this that I am considering writing an article about it for Midwifery Today. The next classes were about taking a prenatal history, doing a basic prenatal exam, the stages of labor, hemorrhage, breast exam, breastfeeding (importance of colostrum; not how, but dealing with mastitis, etc.), fertility awareness method (some access to condoms but not much else), and cord burning.

There were 2 main things that I emphasized through out. First, that what I was teaching was practical for attending births in the jungle. They had been taught some about birth already but so much of it was over-medicalized and appropriate only for hospital. For example, how can someone go in and teach about a "managed 3rd stage" when there is NO PITOCIN AVAILABLE. Or how can someone teach about cutting a cord when there is NOTHING CLEAN to cut it with?? I know these medics will be getting all kinds of information, a lot not evidence-based, and not practical for birthing. Hopefully what I taught will make them think and know that they have other options. Dealing with hemorrhage with only having been taught what to do using pharmaceuticals is dangerous... they needed other options, which I gave.

The second thing I emphasized was working with TBAs (Traditional Birth Attendants). I started by asking a question: "who knows more about birth? TBAs or medics?" They all answered: MEDICS. And so I said, "Oh really? If you have seen 5 births, and a TBA has seen 200 births, who knows more about birth?" Lightbulb moments for all of them, and this opened up a discussion. The medics cannot be at every birth all over their area of northern B-Land. TBAs will continue to be the main source of birth attendants. By working together, they can teach each other. The medics can learn more about normal birth and complications from TBAs while the TBAs can learn about some complications and sanitary birth from the medics.
You can read more on her original post Beautiful B...urm...a. She has several pictures up there as well. I'll just share the best one--a wooden delivery table. Doesn't that look comfy? She wrote about the picture: "The ... birth... bed.... (we had long discussions about this one and we all agreed the floor with a clean mat was a way better option!)"


  1. Thanks for bringing more awareness to birth around the world! This was probably the most challenging trip I've done and I came back recharged and full of more ideas. Yes that birth bed is scary. I had to be really careful not to be critical because they were so proud of it, but after discussions in class, they were starting to think it wasn't such a good place to give birth.


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