The term ‘Laj’ is used by Nepalese women when they speak about their expected attitude and actions surrounding pregnancy. To demonstrate how deeply felt this principle is, Nepalese women will often leave the home and deliver their baby with no outside assistance. Amazingly enough, women are also taught to suppress their cries of labor pains, and stifle screams that normally would accompany any contractions under typical circumstance. The women can be so intent on preserving their honor that they fail to seek help until complications – often life threatening for mom and baby – have arisen.
[Laj is the shame and loss of prestige that will ultimately befall any women who break with tradition](http://www.nsmp.org/pregnancy_childbirth_nepal/index.html) and does what women here at home do, mainly scream, shriek, and have an Obstetrician or other trained birth attendant to assist in the delivery.
Now, for as far as we've advanced, this seems to be a case of one step up and two back. The blood and bodily fluids present with every birth are thought to be ‘polluted and unclean’ by men in Nepal. Due to this perceived tidal surge of unhygienic dishonor, many men will not only not pick up a woman experiencing childbirth complications to transport her for help, he will also be the deciding factor as to the care she will ultimately receive. We can call this the ‘ick’ factor. The level of’ ick’ is, in some cases, the undoing and untimely demise of many women globally. At this point we have to collectively wonder what the problem is. Are the trenches of history so well dug with misinformation and dogma that the tide cannot be turned? What will it take to impart empathy and an urgency to help a woman giving birth? Perhaps it lies in men’s inability to comprehend the pain of childbirth.
Recently, a pair of brave Dutch reality-tv hosts took their cameras into a birthing center, and had (as close as this could be we assume), simulated labor via electrodes attached to their abdomens. The men lasted only ten minutes, and quickly realized how indescribable the pain threshold is. While it is not scientific by any stretch of the cord, it’s heartening to see a couple of men attempt to keep their cool while writhing with contractions. [Watch it here!](http://newsfeed.time.com/2013/01/20/male-dutch-television-hosts-suffer-through-simulated-birth/)
Perhaps if more men experienced the true physical experience of bringing life into the world, they’d be much more quick to help. We can only hope for equal treatment in a life event where women bear the brunt and receive very little assistance.
The BiliDx is a novel system for diagnosing jaundice. The device uniquely meets the Target Product Profile (TPP) developed as part of the NEST 360 initiative in that it allows blood-based testing at the bedside. This initiative is part of an emerging global consensus in the Every Newborn Action Plan that countries need functional WHO level-2 inpatient units to care for "small and sick newborns."
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.