Off to Africa I go, Part 2
by Emily L., S.O.U.L. Maternal Health Volunteer, February 2018
I do want to point out that I do not view either countries' maternal health practices as good or bad, but I am simply stating my own personal observations in order to obtain a good assessment of the overall differences in maternal health in developed versus developing countries.
Also, this list does not apply to every pregnancy in the United States or Uganda and to reiterate again, are my own observations and not facts. Some of my findings are based on observing a traditional “home” birthing attendant, while other findings are based on hospital deliveries in Uganda where the birthing process differs significantly.
OBSERVATION OF DIFFERENCES OF DELIVERY CARE: UGANDA VS. THE USA
Most deliveries occur in hospitals (1.36% in 2012 per the CDC). I have seen a rise in more home births and water births with use of doulas. If any problems arise, especially if you are an at-risk pregnancy, you are already in the hospital with quick access to emergency care or have ambulance services available
If an issue arises during birth, the mother is usually already in the hospital, so they do not have to worry about accessing proper care or being transferred to another hospital
All of the birthing supplies including sterile and disposable gloves, drapes, and gauze is provided by the hospital. The mother does not need to bring any supplies with her except for a change of clothes for herself and the baby. The hospital is in charge of all the supplies and the cost of those in included in the hospital delivery fee
It costs money to deliver a baby in the hospital (both private and public) including hospital stay fees
It appears that a higher amount of deliveries occur within the community or local birthing center rather than the hospital. I found it interesting that even when you give birth in the hospital, you may have to bring your own gloves and other birthing supplies with you. This may cause problems if you are an at-risk pregnancy and do not have quick access to emergency care
If birth is occurring in the community in an area that can not do C-section or handle bleeding complications, the mothers care may be delayed as she has to be transported far distances. Many families do not have vehicles of their own and there is no current ambulance system in place
Women must bring their own sterile and disposable gloves, baby blankets, polyethene birthing tarp, cotton gauze, and umbilical ties with them to the hospital. If a woman does not have the birthing supplies, the hospital staff will ask why she does not have the supplies, care will be delayed, and the women will not receive the same care that a woman with a kit receives
If a woman delivers in a public (government) hospital, delivery and hospital stay is free. If a woman chooses to deliver in a private hospital, it will cost money. This makes it so public hospitals are overcrowded with women in labor as there is no fee to deliver
How S.O.U.L. has helped:
S.O.U.L. provides outreach opportunities with local midwives. Ultrasonography helps families prepare for safe deliveries, including determining date of delivery and position of the baby
S.O.U.L. also provides maternal health classes to teach women the normal signs of labor so that they can get to their delivery location in a timely manner and covers the dangerous signs to look for which could trigger the women to go to a hospital sooner
S.O.U.L. provides “Mama Kits” with supplies that the mothers can bring with them to the hospital at the time of labor. The “Mama kits” act as an incentive to get women to attend the maternal health classes
S.O.U.L. is starting the process of using an emergency vehicle for faster transports of pregnant women
Due to overcrowding of public hospitals and delay of care, S.O.U.L. is hoping to create a local birthing center to assist with this problem and overall improve the care of mothers and babies
OBSERVATION OF DIFFERENCES OF POST-DELIVERY CARE: UGANDA VS. THE USA
It is highly recommended that women have many follow ups with a nurse, midwife, or doctor post delivery to assess the baby's health, growth, feeding, and any other issues (2 weeks, 2 months, 4 months check-up, etc.)
Women stay at home initially for maternity leave and is more of a shared involvement of both the mother and father
Babies are breastfed and then transitioned to formula or milk, then are transitioned to soft foods when they reach a certain age
Postpartum follow up does not appear to be as set in stone. The mothers may wait to take the children to the doctor or clinic only when they are sick instead of taking preventative measures
It appears that most babies are breastfed and then transitioned straight to soft foods. Does not appear to be as strict of a timeline of when to transition the baby to different foods
Women often stay home with the children while the husbands/men are working to make money to provide. Appears to be slightly less of a shared involvement of the mother and father
How S.O.U.L. HAS HELPED:
S.O.U.L. teaches the women about postpartum depression and what the women may expect after birth
S.O.U.L has offered maternal health classes to men to get them more involved in both the labor and postpartum stages so they can know what to expect and how to help
S.O.U.L. has collaborated with the governmental health organization to send general text messages to mothers from the beginning of their pregnancy up to 6 months after the baby is born. The mother will receive helpful educational messages throughout this time including helpful tips on subjects such as lactation, antenatal visits, maternal diet, and maternal health. The mother cannot ask questions through this service, but hopefully this can be expanded to include that service in the future.
So what I learned in a nutshell….
Now as you can see, there are many differences between maternal health in the United States and in the areas of Uganda that I visited. After my visit, I believe that S.O.U.L. Foundation is truly doing so much to improve maternal health education in Kyabirwa in attempts to ultimately decrease infant and mother deaths. If I had to make one overall conclusion from my time here in Uganda, it would be that the quality and presence of maternal health education and practices around the world depends almost entirely on the resources that are available.
If any country in the world is given the resources to provide proper education for expecting mothers and adequate supplies for safe deliveries, the importance of maternal health would grow and outcomes would improve! Luckily, S.O.U.L. Foundation has become a vital resource to Kyabirwa and its neighboring villages. From what I can see, the resources that S.O.U.L. Foundation provides will continue to grow and impact more people every day!