We believe there is a tipping point for each community--a point where the access to full backup in the case of obstetric emergencies is perfectly balanced with the preservation of important community psychological and spiritual supports.
In the week after the national Women Deliver conference, it's a good time to pause and reflect briefly on where we are. As a global movement, maternal health has made great strides. More women have access to professional skilled attendants, yet we know that quality of care and respectful care is an unrelenting challenge.
This interesting story from [Alberta, Canada, provides an great counterpoint to the push for facility based births(http://www.newtrail.ualberta.ca/en/FeatureStories](FeatureStories%20Current/CopyofBringingBirthBacktotheNorth.aspx).
The traditional infant carrying parka, the amauti, is shown here. An excerpt from the article appears here with permission from the author (Sarah Ligon)
"When U of A professor Beverley O’Brien began working in the North as a nurse practitioner in the early 1980s, she rarely attended births. Although the communities in what is now known as Nunavut where she lived were small — Pagnirtung (current pop. 1,550), Igloolik (1,450) and Hall Beach (650) — they had some of the highest birthrates in all of Canada. But at the time, the policy of shipping all expectant mothers down south was at its height. “I was told by my supervisor that it would only be my mistake that resulted in a baby being born at a nursing station,” says O’Brien.
The survival of a community has a lot to do with the ability to give birth and to continue the community. If they can't do that, it's almost the death of the community. Isn't it? -Beverley O'Brien
O’Brien’s experiences in the North — and the birth of her own son years later — taught her that there had to be a better way to have babies. So, she trained as a midwife and embarked on an academic career that has focused on providing midwifery care to women in Africa, Asia, the North and here in Alberta. Then, in 2006, she was approached by Nunavut Arctic College to develop a program that trains local women as midwives and maternal care workers — one that includes traditional Inuit knowledge about birth while meeting high Canadian midwifery standards
Now, as the acting co-ordinator of the midwifery education program, she works with a team of administrators and southern midwives to select students in three communities across Nunavut — Rankin Inlet, Cambridge Bay and Iqaluit — and craft an educational program suitable to their unique needs and their location."..
"Although most residents of Rankin Inlet are fluent in English, many of the women from smaller surrounding communities are more comfortable speaking their native tongue. “We find that when somebody is in pain, their mother tongue tends to come out,” says Jones. “I’ve heard a lot of women say it was so much easier to be in labour and to be able to speak Inuktitut.”
The article provides a cautionary tale-- in the rush to get women to facilities, we need to be very careful not to remove the 'community' from the birth process, nor the birth process from the community.
Credit: Thanks to Elizabeth Holland from RISD for alerting us to this important article Citation: University of Alberta Alumni Magazine, November 2012.
Now as a next step, we ask what could be done to lower the costs of the implementation of the E-MOTIVE bundle? The most obvious answer is to consider displacing the tens of thousands of disposable plastic drapes with a purpose-built reusable device.
Fortunately one of the obstetricians involved in the E-MOTIVE study, Dr. Justus Hofmeyr, had been innovating around this very issue, designing a tray with wells that could fit under a woman’s buttocks, collect and accurately measure the. blood. This tray, theMaternaWellTraywas conceived as a device that could be sterilized and reused, and is manufactured in South Africa by Umoya.
The Pumani bubbleCPAP was designed to meet this need for Malawi and is now widely available through Maternova. We had a few questions about post-research phases of the Pumani bubbleCPAP which we posed to Jocelyn Brown, inventor of the Pumani bubbleCPAP, and Molly McCabe, Director of Product Management.