Addressing maternal mortality in Bolivia: women say 'respectful treatment is crucial': Ulrika Rehnstrom, a midwife with the United Nations Population Fund, describes the current situation in Bolivia where it is hoped to scale up midwifery education.To go through childbearing without risking your life is a human fight, yet pregnancy and childbirth are still the leading causes of death and disability for women of reproductive age in Bolivia. Every year approximately 650 women die as a result of complications from pregnancy and childbirth; 47% of these women are aged less than 30 years. Most maternal death Maternal death, or maternal mortality, also "obstetrical death" is the death of a woman during or shortly after a pregnancy. In 2000, the United Nations estimated global maternal mortality at 529,000, of which less than 1% occurred in the developed world. and disability could be avoided if births were attended by a qualified midwife with access to relevant equipment. Ensuring skilled care for all births is a prerequisite for making sure that those women who develop complications can get timely emergency obstetric ob·stet·ric or ob·stet·ri·cal
Of or relating to the profession of obstetrics or the care of women during and after pregnancy.
pertaining to or emanating from obstetrics. care.
Millennium Development Goals “MDG” redirects here. For other uses, see MDG (disambiguation).
The Millennium Development Goals are eight goals that 192 United Nations member states have agreed to try to achieve by the year 2015.
Bolivia adopted the UN's Millennium Development Goals (MDGs) in September 2000, including the objective to reduce maternal mortality by three-quarters (Goal 5) before 2015 and ensure that at least 90% of women receive care from a skilled birth attendant during labour and birth.
The current maternal mortality ratio maternal mortality ratio Epidemiology The number of pregnancy-related deaths/100,000 live births. Cf Maternal mortality rate. is 230 per 100,000 live births in Bolivia--one of the highest in Latin America Latin America, the Spanish-speaking, Portuguese-speaking, and French-speaking countries (except Canada) of North America, South America, Central America, and the West Indies. . In rural areas where the population is mainly indigenous people, the rate is even higher. In some parts of the rural high plateau the ratio is 887 per 100,000 live births, which clearly shows the existing social and economic disparities.
Traditional methods of care
In Bolivia, pregnant women do not have access to professional midwives. Unfortunately the midwifery midwifery (mĭd`wī'fərē), art of assisting at childbirth. The term midwife for centuries referred to a woman who was an overseer during the process of delivery. In ancient Greece and Rome, these women had some formal training. training that once existed was discontinued. At the present time, women in urban areas are attended by medical doctors, while in rural areas, auxiliary nurses take care of women in labour. Auxiliary nurses have a training of minimum six months, sometimes up to two years, in general health.
The traditional methods of care in the Bolivian rural areas are very different from the modern medical system. Traditional systems are highly valued within Bolivian communities. Many rural women are afraid to give birth within the health system, fearing that their culture and beliefs about childbirth will be ignored. Many women in Bolivia say that respectful treatment is crucial and that the disrespectful dis·re·spect·ful
Having or exhibiting a lack of respect; rude and discourteous.
disre·spect attitude of service providers is a major factor in their decision not to utilise maternal health services. Instead they choose to give birth at home assisted by their family. In a case when a complication arises, this may put at risk the women's life or her baby's.
The Nursing College of Bolivia, selected universities from the Bolivian university system and the United Nations Population Fund The United Nations Fund for Population Activities (UNFPA) began funding population programs in 1969. It was renamed the United Nations Population Fund in 1987, but kept its original abbreviation. (UNFPA UNFPA United Nations Population Fund (formerly United Nations Fund for Population Activities)
UNFPA United Nations Fund for Population Activities (now United Nations Population Fund) ) propose to implement midwifery education to degree level in Bolivia, with the mission to improve sexual and reproductive health for all, using a culturally sensitive and ethical approach. The professional education of midwives would concentrate on training them to care for the holistic needs of women in a competent manner, acting as women's advocate and working with them and their families to promote a sale and fulfilling childbirth experience.
The midwifery programme would promote:
* a philosophy of individualised Adj. 1. individualised - made for or directed or adjusted to a particular individual; "personalized luggage"; "personalized advice"
individualized, personalised, personalized , women-centred care
* equality for all women regardless of race, religion or age
* safe maternity care with an integrated reproductive health approach
* increased awareness of sensitive and compassionate care for family and sexual health problems both on an individual and wider level.
Initially this proposal was not well received by some in the country, who wanted to continue the training of auxiliary nurses. However, due to the positive approach by UNFPA, it was soon realised that such a programme would contribute to the improvement of sexual and reproductive health for the whole population--men, women and adolescents--with particular attention paid to socio-cultural aspects.
The government, in the middle of 2006, finally opened the discussion to start the pilot project 'To Institute the Career in Midwifery within the University System of Bolivia'.
The next step of this project is to prepare the curriculum for both midwifery students and midwifery teachers; after that will follow the training of teachers in midwifery. Authorities from the universities, nursing colleges and ministry of health, with assistance from UNFPA, PAHO/WHO and midwifery experts from Peru and Chile, will work together to develop a culturally sensitive programme for midwives.
UNFPA is convinced that scaling up midwifery is the strategy to reduce maternal morbidity and mortality Morbidity and Mortality can refer to:
For further information, please contact Ulrika Rehnstrom at firstname.lastname@example.org