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Janet Jarman – August 31, 2015
The
Midwife, in Chiapas, Mexico - Video
In Chiapas, Mexico, a midwife may be the only person there to help a woman when she gives birth.
http://www.nytimes.com/2015/09/01/health/midwife-mexico-chiapas.html?_r=0
Website Link Also Includes Video.
TRAINING MIDWIVES TO SAVE EXPECTANT MOTHERS IN CHIAPAS
By DENISE GRADY
– August 31, 2015
Chiapas, the southernmost state in Mexico,
is a mix of wonder and sadness. It is home to rain forests, Mayan ruins,
waterfalls, rugged highlands — and some of the country’s highest death rates
among women in childbirth.
Pregnancy and birth are not illnesses, and yet
they are a significant cause of death in young women in developing countries.
Globally, complications of pregnancy or delivery killed 289,000 women in 2013,
almost entirely in poor countries. The toll was far worse in 1990, when more
than 500,000 women died.
But the improvement in recent years falls short of goals set by the United
Nations, which called for a worldwide decrease of 75 percent in
maternal mortality by 2015. The death rate remains “unacceptably high,”
according to the World
Health Organization.
The figures are inexcusable, experts say. With proper, basic health care,
nearly all deaths during pregnancy and childbirth can be prevented.
The story in Chiapas is much like that in other impoverished regions around
the world. Wherever maternal deaths are high, the main reason is the same: not
enough doctors, nurses and medically trained and equipped midwives to help deliver babies.Health By JANET JAN Pl
Calling the Midwife, in Chiapas
In Chiapas, Mexico, a midwife may be the only person there to help a woman
when she gives birth.
When something goes wrong during birth, it can happen suddenly, leaving no
time to spare. It does not take long for a woman to bleed to death after giving
birth, especially if she doesn’t have expert help, the right medications and
access to blood transfusions. Hemorrhage is the leading cause of maternal
mortality worldwide.
A number of factors put women at risk in Chiapas. The region is poor, and
many people live without cars along rough roads far from hospitals. Women often
give birth at home, and if they get into trouble, it may be impossible to reach
a hospital in time. Or a woman’s husband or in-laws, adhering to tradition or
worried about the expense, may refuse to allow her to go to the hospital.
The indigenous groups native to Chiapas have, for generations, had their
babies delivered at home by traditional midwives, or parteras. These midwives
handle normal births with ease, but most lack the training, medicines and
equipment needed to deal with obstetric emergencies like hemorrhage, high blood pressure and infection.
Nonetheless, the midwives are respected and loved for their skilled hands
and wisdom, and for the warmth, affection and comfort they bring to women in
labor. At least half the women in indigenous communities in Chiapas still rely
on traditional midwives.
Many of these expectant mothers fear and dislike hospitals, seeing them as
cold, unaffordable places where medical personnel may not speak their language,
and may discriminate against them and treat them and their traditional midwives
disrespectfully. Many native women dread being urged into beds during labor
instead of being free to squat or take other upright positions that they find
more comfortable for giving birth. Some women fear that hospital staff will
force them to have cesarean sections.
But the statistics in Chiapas cannot be ignored: Researchers estimate that
for every 100,000 women who give birth, 55 or more die, a rate significantly
higher than that in the rest of Mexico.
Aid groups and the Mexican government are trying to help Chiapas.
Photographer Janet Jarman traveled extensively in the region last fall and
winter, documenting the old ways and the new, and the places where they meet.
One program brought midwives with medical training to a government hospital
in the hopes that their presence would attract women. Another offered training
to traditional midwives. A new birth center was opened in one town, staffed by
professional midwives and set up to create an experience as much like a home
birth as possible, right down to providing a rope that dangles from the
ceiling, for a woman to grasp and pull on during contractions.
The new programs aren’t perfect. The traditional midwives have complained
that there is not enough instruction and that equipment they had been promised
never appeared.
Even so, officials say they are cautiously optimistic, and the maternal death rate in Chiapas has begun to come down.