18 June 2019
International Day of the Midwife was celebrated last month on 5 May, and this year’s theme was "Midwives: Defenders of Women's Rights."
The health of women and children is a major cause for concern for Palestinian refugees in Lebanon, with rates of maternal and child mortality and morbidity remaining high. Medical Aid for Palestinians (MAP)’s team of community midwives play a vital role addressing this, providing the only home-visiting midwifery service in Palestinian refugees camps in Lebanon.
In 2018, the American University of Beirut assessed the impact and added benefit of MAP’s maternal and child health (MCH) programme to the existing UNRWA services, and reported that “MAP has significantly contributed towards a positive shift in its impact on maternal and neonatal health outcomes.”
The community midwives have helped to increase breast-feeding rates, significantly reduce anaemia among pregnant women and new-borns, reduce high-risk pregnancies, pre-term births, and the rates of caesarean section deliveries among Palestinian refugees.
To mark the occasion, we sat down with Amneh, a MAP community midwife, to discuss how she and her colleagues are promoting the rights to health and dignity of Palestinian mothers and their new-born babies.
“Since a young age, I knew that I wanted to be a midwife. At one point when I was growing up, my mother had a reproductive health problem and she suffered a lot. She went to many female gynecologists, and with every doctor, the problem got bigger and bigger and she was put on different medications. The problem was a very simple one; one that could have been prevented through a family planning counselling session with a midwife. Since then I decided to be a midwife in order to help women like my mother. I believe that a healthy mother means a healthy family.”
“Our work is physically demanding yet very rewarding. Feeling that I have helped a mother or saved a baby’s life is totally worth all the hard work. When a worried mother calls for advice at a late hour, I respond immediately because I value her trust.”
“During pregnancy, health education and health promotion are key. Doctors at UNRWA and many private clinics do not provide enough time for health education due to their large workload. For example, the average consultation time at UNRWA clinics is only a few minutes.
“MAP midwives visit pregnant women at their homes at a time that is suitable for them and give them the time that they need. We [MAP midwives] do not just give the information and leave; we have a discussion with each pregnant woman focusing on her individual needs and what suits her situation best. When we understand her needs and tailor the advice accordingly, the woman will give us all her attention as the information will be relevant and of interest to her. This way the benefit is maximised. When we help, women have healthy pregnancies, we are contributing to reducing complications and hence morbidity and mortality, as well as physical, psychological, and financial burdens on women and their families.
“In the MCH project, we continue to visit women after childbirth. We visit the new mother a few days after her discharge from the hospital, and we give her information related to newborn care, provide her with breastfeeding counselling and support, explain to her danger signs, etc. Home visits during this period are very important as, in our community, there are many misconceptions and traditional practices related to newborn care that should be addressed. For example, many women believe that they should stop breastfeeding and instead give sugared water to newborns who have jaundice. We give them evidence-based information in a simplified way. Also, many first-time mothers feel afraid to bathe the baby or to touch the umbilical cord area. We show them how to hold and bathe the baby and clean the cord area and explain to them related danger signs.
“The first visit after childbirth is critical as we can identify, and support women affected by 'baby blues'. They think that what they are going through is shameful and feel embarrassed to even speak about their feelings and thoughts. I see women open up to us when I explain to them about baby blues and that it is common among new mothers.”
“As a community midwife, I need to work with different people who have different backgrounds, personalities, ways of thinking and communicating, etc. With every woman, I need to use the approach that will be most effective. The community midwife needs to have excellent communication skills and know how to manage a conversation. For example, when some women try to challenge you or prove you wrong, you need to be patient and explain the scientific information in a suitable way. You should respect all people and their experiences, and work to correct their misconceptions in a smart and polite manner.”
“I hope the project continues for a long time in order to help more and more mothers.”
MAP is very proud of the community midwives, and celebrates their work not just on International Day of the Midwife, but all year round!
Would you like to support our Maternal and Child Health programme in Lebanon? Please donate today: