Wednesday, August 13, 2008

Living in a bubble

I am the first to admit that I live my life pretty much oblivious to anything except my immediate family, friends and work context. I am reasonably attune to what's going on in the midwifery world in New Zealand and countries such as the UK and Australia. On the whole I have been oblivious to what is going on in developing countries with regards to childbirth.

Social networking raising my awareness
But my awareness of the problems faced by my midwifery colleagues and birthing women has increased over the last few months. This has come about as I have used social networking tools to connect with individuals and midwifery networks in developing countries.

The torture of birthing women in the Dominican Republic
It is through one of my midwifery networks that I came across Stacey Sheer, who is a midwife trying to raise awareness about what is happening to birthing women in the Dominican Republic. Stacey has written to the World Health Organization pleading for conditions for women to be improved, especially by improving obstetric and midwifery education. Stacey says:

I am still in shock from the horror of the behaviors I witnessed in this countries public hospital. The standard of care for a laboring woman is this:
Laboring women, labor in one room with sixteen beds and sometimes three women to a bed at a time. There are no clean sheets or chux on these beds, they are in their street clothes, body fluids are expelled on the floor or on the bed, all waste products are released in the bed or on the floor by the side while they labor. The women are not given food or water to drink.

She goes onto say:

One day I witnessed an intern cut a woman on both sides and a third time into the rectum; the head was not even visible and no one took a heart tone. This woman was left with a gaping hole in her pelvic floor which words cannot describe.

Another horror
I witnessed the doctor opening the scissors to find they had blood on them from another woman. She called for a nurse and none came; she used them anyway to cut this woman.

And on:
After the baby is forced out of the woman's severely compromised vagina, the doctors immediately clamp and cut the umbilical cord depriving the baby of its blood. The baby is whisked away to another room and the doctor immediately pulls on the cord of the still attached placenta until the woman hemorrhages and the placenta is expelled. Three times in one hour I witnessed projectile expression of copious amounts of blood at this pulling.

What can I do?

I do not normally sign petitions or pass on stories like this. And to be honest, I don't have any real idea about what I can do. So I am re-telling this story to make you mindful of what goes on in some areas of the world, and express my support for Stacey's campaign.

If you wish to hear more about Stacey's experiences and show her your support, please contact her at stacy.sheer(at)


Anonymous said...

That is just hideous!

I wish there was something more we could do!!!

Sarah Stewart said...

I guess the first thing is to reflect on how lucky we are in New Zealand for our maternity services and credit where credit is due to both midwives, obstetricians and pediatricians.

One midwife, Kathy Carter-Lee, wrote a wonderful response to this on one of the midwifery emails lists I belong to (

I quote:

"It may sound like I am on a soap-box here, but I think it is important for us all to realise that we ALL have opportunities to do something about the sort of situations Stacey has experienced. We all have opportunity to support increase of knowledge, change of attitudes in other countries maternity systems. I list below some ideas, which others may add to:

* supporting Non-Governmental organisations to make sensible plans for their mother and child health programmes

* asking key questions of academics and policy makers in our foreign aid organisations

* participating in preparing training material or teaching in such situations

* facilitating access by countries to up to date information on maternity care eg. on-line article access, translating articles for non-English websites or publications etc

* taking time to get to know a foreign midwife working or studying in our own country and keeping contact

* we need to try to understand the constraints some of these people work under, which are not just limited to funding, but are often a result of their institutional culture preventing them from "sticking their necks out" to push for changes in their institutions. Training is needed, but ongoing support to implement what has been learned is vital to make the training mean something.

As Stacey has encouraged us, there needs to be action when we know care is not good. Action is needed on both an individual and institutional level - we have opportunities if we decide to take them."

Carolyn said...

Maybe the next ICM, after South Africa should be in South America. Perhaps this could raise awareness and support change, although I know this is a long way away. Change here will not happen overnight though so it might be worth considering.

Stacy said...

Thank you for spreading the words-Stacy

Sarah Stewart said...

Thank you, Stacy for raising the issue. The response internationally in the midwifery world has been great already. Thank you making me think outside my comfort zone.