Is water birth the next technique to saving lives of women in Ghana?

Ghana’s maternal mortality went up from 350 per 100,000 live births to 380 in 2014, according to the Maternal Mortality Estimation Inter-Agency Group of the World Health Organisation.

However, another report,  the Ghana Demographic and Health Survey (GDHS) shows that infant mortality rate for the country has declined in the last 25 years.

“This decline is especially pronounced over the last 10years. For example, the infant mortality rate declined from 64 per 1,000 for the five-year period preceding the 2003 GDHS to 41 per 1,000 during the same period prior to the 2014 GDHS,” it says.

Despite the the bright picture painted by the statistics, many women and children still die during the process of birth.

There is however, one woman who believes that this shouldn’t be happening.

Sarah Serwah Major, head of the Maternal and Child Birth Services at Craddle Care, says these deaths can be completely prevented if midwives take simple birth practice precautions.

For her every birth process should be seen as a fatal one which needs proper care from a midwife from the pregnancy stage to giving birth.

After working as a midwife in the UK for 12 years, Major decided to come back to Ghana to set up a maternal health care facility to make a difference in midwifery with modern methods.

“When I came to Ghana I was wondering why most women would go to have a baby and just die as a result and I realised that they die because of the health professionals attending to them but not through their own deliberate fault.

“I have helped 42 women give birth since I started in 2014 and all these births were devoid of complications and I believe the midwives in Ghana could do same. I believe the role of a midwife is to support women to give birth but I do not see our midwives doing that,” she lamented.

Water birth

Her facility which is the first in Ghana to offer water birth services has so far provided ten water birth services since its inception. “Water birth causes less pain and it is a much calmer birthing method,” she said.

According to her most Ghanaian women visit her facility to have water birth because they believe it is a trend they have to keep up with.

“Most women approach me that they want to have water birth but not everyone can have a water birth process.”

“When a woman comes to me for delivery, I draw a birth plan first and I make a complete assessment of her and her pregnancy. First the woman should be full term, 37 to 42 weeks, the woman should have an uncomplicated pregnancy which means no high blood pressure, no gestational diabetes, no infection and the woman should have a Body Mass Index below 30 before I consider her  for water birth.”

“Additionally, in the process of water birth the woman should be five centimeters dilated before going into the water because it slows contractions,” she indicated.

Water birth is a non-touch birthing method, meaning you don’t have to touch the baby. You only encourage the women to push because once you touch the baby it starts breathing and it may swallow water which may go a long way to cause complications, she said.

Major disapproved of the practice where Ghanaian midwives allow women in labour to lie down to give birth since sitting or standing is the best position.

“National Midwifery Council needs a transformation to prevent maternal deaths,” she said.

Major also says the government is not investing enough in the midwifery practice and that the trend needs to be reversed to continue to reduce maternal mortality.

“The foundation of our midwifery educational training is weak. One and half years midwifery training and one and half years nursing training is simply not ideal,” she said.

She noted that mandatory training and retraining for midwives to update themselves with current midwifery practices to meet the current demands and provide up to date services to women was necessary to reduce infant mortality rate.

“The National Midwifery Council needs to research and look at the whole training system in our nursing training colleges  so that they are provided with requisite knowledge needed to meet current trends in the practice,” she added.

She also suggested that community midwives should be given mobile phones to provide 24 hour call centre services so they keep regular contacts with pregnant women to avoid unnecessary complications.

“The number one cause of maternal deaths in Ghana is caused by postpartum hemorrhage and it happens as a result of the four T’s usually overlooked by our local midwives,” she stressed.

First is Tissue – This is where a bit of the placenta is mistakenly left in the woman after she delivers.

Second is the Tone -This is where the uterus wall contracts leading to bleeding.

Followed by Trembling – Which is when a woman’s platelet is low leading to excessive bleeding.

Trauma which is the last of the T’s is where probably because of the baby’s weight it causes a tear which usually causes postpartum hemorrhage.

On Cesarean section birth method, she advised pregnant women not to follow the craze which is on the rise but should only opt for the method when they are at high risk of undergoing the normal birth process.

By Pamela Ofori-Boateng

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