Amid RH bill row, group trains midwives, sets up birthing clinics

While the reproductive health (RH) bill is stirring debates inside and outside Congress, how is the number of women dying at childbirth being reduced in Pampanga?

A group is doing its bit by training “komadrona” (midwives or birth attendants) and setting up birthing clinics run by midwives.

“They’re on the frontline of caring for pregnant women,” says Sylvia Ordoñez, secretary-general of the Kapampangan Development Foundation (KDF), when asked why the group’s Pampanga-Zero Maternal and Infant Mortality Movement has focused on upgrading the skills of midwives.

The project, running for two years now, is supported by a  P3.5-million grant from the Philippine Long Distance Telephone Co. (PLDT)-Smart Consortium to help the Philippines meet its targets for the United Nations Millennium Development Goals (MDG), Ordoñez says.

The MDG is a set of poverty-alleviation targets identified by UN member-states and the world’s leading development institutions. The goals range from reducing extreme poverty to stopping the spread of HIV/AIDS and providing universal primary education by 2015.

More than 2,000 midwives attended the seven training sessions the KDF had organized together with the Philippine League of Government and Private Midwives and the Pampanga health office.

Ordoñez says the training program tries to bridge the gaps in the skills and knowledge that were not met in the old curriculums. Years ago, she said, the courses did not teach stitching wounds or administering intravenous medicines.

The KDF has set up birthing clinics in Apalit, San Simon and Lubao towns. Nine more are expected to be established in the province.

Hemorrhage (bleeding), obstructed labor, unsafe abortion, sepsis (blood infection) and eclampsia (seizures in pregnant women) are the top causes of maternal deaths in the Philippines, according to Dr. Violeta Manalang-de Guzman, a member of the MDG task force, citing a World Health Organization study.

Maternal deaths in the country in 2011 rose to 221 per 100,000 live births, while child mortality dropped to 30 per 1,000 live births. The targets are to bring the figures down to 52 and 27, respectively, according to the Department of Health.

De Guzman calls midwives “pick-up points” because complicated birth deliveries are first brought to their attention. Midwives are bound by health protocols to immediately refer these patients to hospitals, she said.

Some malpractices among midwives occur though, Ordoñez says.

Like doctors, midwives working in the government are allowed to do private practice. Since they charge only P2,500 to P5,000, some midwives tend to hire unskilled or unlicensed birth attendants or nurses who cannot handle complicated

cases, Ordoñez says.

Some allow extended labor to earn, but De Guzman says delaying the delivery puts both the mother and child at risk. “The so-called dilemma of who to save, the mother or the baby, exists only in the movies or television. The priority is the mother,” she says.

The standard rule is that midwives can only assist women who underwent prenatal checkups in their clinics, says Marilyn Maglalang, a midwife of 37 years.

She says midwives must undergo continuing professional education so they can renew their licenses every three years.