Birthing in the 3rd world

Expanded supply of breast milk to premature babies

2013-04-11T07:21:00.000-07:00

http://www.espectador.com/noticias/260608/ampliaran-suministro-de-leche-materna-a-bebes-prematuros

The Alvarez-Caldeyro Barcia Foundation expand its coverage of human milk nationwide. The organization, which works in the survival and development of premature infants, will open in late April the new facilities of human milk bank.

The new infrastructure, built largely thanks to the contributions of the Government of Japan and the Lions Club International, will expand the supply of breast milk to babies born nationwide soon.

Human milk ensures all enzymes and nutrients essential for the development of babies and is especially critical for those born before 37 weeks gestation, usually affected by low weight and gastrointestinal diseases.
Many of these children have not yet developed the ability to suction, allowing them to be nourished directly from their mothers, who then fail to produce enough milk to feed their children, the result of stress and nervousness that generates them the situation.
The human milk bank in the Pereira Rossell, a pioneer in Uruguay, receives an annual grant of approximately 600 lactating women who work with the Foundation program Alvarez-Caldeyro Barcia.
On site, the milk is stored, studied and pasteurized before being fed to premature infants.

According to data obtained in 2009 by the Administration of State Health Services (ASSE), about 4,500 children are born prematurely each year in Uruguay and 15% of all births in the Pereira Rossell correspond to preterm delivery.
In 2012, the bank achieved coverage to 1,143 babies. Anyway, there are some shortcomings of human resources and infrastructure.
Some of the flaws are easily fixable through donations, such as the shortage of glass containers with threaded plastic cap for milk collection, breast pumps or manual or electric refrigerators for shipment conservative.

"We work in coordination with the Pereira Rossell Hospital volunteers and all donations are welcome. Our foundation is in the Pereira Rossell Hospital, has its facilities open to all donations on a schedule of 10 am to 18 pm ", concluded Argimón, President of the Bank.

The phone for donations is 2 708 1334, from 10 to 18 hours.

Too sad: woman died during delivery in Tacuarembó

2013-03-20T13:51:00.000-07:00

Spanish source: http://www.montevideo.com.uy/notnoticias_195721_1.html

A 35 year old woman died in the delivery room of the Hospital of Paso de los Toros, Tacuarembó, due to placental abruption. In the health center there was not an anesthesiologist or a surgeon who could deal with the emergency. Her baby was born and is out of danger.

The hospital did not have at that time an anesthetist or surgeon, and decided no to leave to the nearest hospital, (which is 40 kilometers away) because there was no time and was at risk the baby's life.

Hospital Director of Paso de los Toros, Alfredo Fraga, told that the child was born alive but the mother died shortly after.

"If the hospital had all professionals working in the health center, women probably would have survived," said Fraga.

In Paso de los Toros's hospital there two gynecologists, two surgeons and two anesthetists, but one of the last had an accident, so the remaining in office had to work 24 days in a row. The day he took off, the unfortunate episode occurred.

"I can not have one person for 30 days, 24 hours a day working," Fraga said on the radio to the local station 100.1 FM.

Amidst this scenario, Paso de los Toros anesthesiologist will have all week of Tourism free, because of his working license, so all cases requiring surgery will be referred to the nearest Hospital.

"No one is coming to Paso de los Toros to make a guard for less than $ 2,000 per day (100 american dollar), ASSE pay $ 79 ($4 amercan dollar) a hour to a specialist, either anesthesiologist, gynecologist or pediatrician, and with that remuneration no one is going anywhere, "said with concern the hospital director.

New law proyect to promote new births

2013-03-17T18:32:00.002-07:00

The heart of the initiative considers infertility and sterility "as a chronic disease that causes in people the inability to conceive or carry a pregnancy to term,".

In this sense, assisted reproduction should be a benefit provided by public and private entities. This includes "coverage necessary diagnostic studies of infertility or sterility, treatment and other required studies, disposable material, therapeutic procedures Assisted Human Reproduction High and low complexity, potential complications and appropriate medication in all cases" .

In the preamble to the project recalls the World Health Organization (WHO) classified as infertility and sterility as a disease of the reproductive system, causing illness in people's inability to get conceive or carry to term pregnancy. "Infertility / sterility negative impact on the mental health of couples who suffer and affect real and effective in their quality of life, the breed, as well as being a right, is part of psychophysical health of the couple," says Lacalle Pou.

If this law is approved, any couple with difficulties to get pregnant will be assited by their own health service with no extra charge.

Give birth as I say, how I say, and with whom I decide. Open letter of Midwife Sylvia Sosa.

2012-08-30T19:35:00.000-07:00

My name is Sylvia Sosa. Midwife for 14 years, graduated from the School of Midwifery, School of Medicine, University of Uruguay (UdelaR).

I chose to become a midwife after my experience with the birth of my first child. Informed and aware of what it meant, with the father of my child, we chose to give birth "at home." It was an easy decision. I’ll be eternally grateful to the team of midwives who assisted me at the time. They made my birth experience unforgettable, it was the most empowering event of my life. We gave my son, Nico, the arrival and reception to this world that I, and his father, wanted for him. This was how I discovered midwifery, an art from all time, accompanying women during childbirth. We support and facilitate the experience. At that time I decided to enter this world so special and magical.

On Saturday, August 11, it was published an interview the newspaper “El Observador” made me regarding “Nacer Mejor”. This is an organization dedicated to pregnancy, birth and upbringing, which also works with home births.

Huge was my surprise to read a box at the end of the note, citing a phone call to Dr. Briozzo, undersecretary of the Ministry of Public Health which says: At the initiative of Obstetric Association of Uruguay, we are studying a regulation of professional practice (midwifery practice) and precisely one of the issues on the table is the prohibition of the exercise at home when planned. "This is a topic that is being discussed in the orbit of the ministry and could go by presidential decree"

My surprise was great, but greater still was my indignation. None of this is accidental. It is the continuation of the threat that the same Dr. launched last year, saying they were going to ban home births. At that time there was a strong response that this went against the right of every woman to decide how, where and with whom to give birth. A few days afterwards, he rectify that no one thought of a ban, but to discourage its practice. Now back to the load, this time he is against the free exercise of the profession, exercised by those midwives who attend home births. As if something is not the same as the other ... and out talking about a presidential decree: Who has been an abuse of power so great?

With such presidential decree, the political power would deny assistance to those families who responsibly and freely choose a different model than the institutionally established for the birth of their children. Isn’t going against our human rights? Isn’t against my right as a woman to decide on my body?

It is very striking how Dr. Briozzo, devotes such effort to combat home births, when evidence-based medicine has proven to be a safe option for low-risk births. He should invest energy and time to develop strategies that alter perinatal obstetric outcomes of institutional births. How this ministry failed to reduce cesarean rates that are far exceed the internationally recommended by WHO?

I wonder if Dr. Briozzo would held responsible for the obstetric outcomes of women who choose to give birth at home but WITHOUT technical assistance.

A world in which prevail dignity and respect, in which women are treated with equal rights, mainly in the magic moment of the birth of our children, can never be ruled by any powers, neither the doctor nor the male, or the politician.

Only that this time they go to the load in partnership with the Association of Obstetric Uruguay. A real shame.

With what authority the Obstetric Association of Uruguay is working on a project of this nature without consulting midwives? With what authority a board consisting of a few colleagues, works on a project that delivers our free practice without consulting the other. Not to mention the lack of participation of the School of Midwifes itself, which is the academic responsible for our training?

The directors shall have powers to many things, but I think in no way includes developing with Dr. Briozzo a modification of this nature without the support of midwives in this country.

Our free exercise is historic; it's part of our profession since it exists. For years we have being displaced in our exercise, and cornered by submerged salaries from medical corporatism, which has been gradually removing many of our fields. I hardly attend births except public, while in private we don’t even do pregnancy checks.

And I wonder, midwives agree to deliver our free exercise of the profession just like that?

I choose my free exercise for me and for all .... Free exercise allowing each to work the way you choose.

Respect to those practicing in an institutional framework because they like, or because they do not look

elsewhere ... but I defend my right to attend all those who come looking for a different birth for their children .... In their homes.

The historic site of the midwife has been next to women and families, accompanying one of the most important moments of their lives, which marks their future history, as women, as couples and as families.

This is not intended to be a discussion of childbirth at home. It’s a call for our collective consciousness.

It is no coincidence that in Argentina entered parliament a draft law banning assisted home births and that Brazil is on the same road. For me is a deep pain that in Uruguay this attempt is in complicity with my own colleagues.

I call to reflection and collective action:

To request that the authorities of School of Midwives, take action on the matter.
For all Uruguayan Midwives, to defend our right to free practice.
For the members of the Association of Uruguay Obstetric convene a National Assembly where all midwives can decide.
To collectively censure those colleagues willing to give our free exercise just like that.
To request that this call be made widely available to all midwives in this country. I forward this to my colleagues, to be printed and show in every guardroom.
For all women and their families to continue to defend our right to decide how, where and with whom to give birth to our children, in a safe and professional assistance.
To make all the necessary political contacts so it doesn’t come true the actually mentioned Presidential Decree.

On this depends that our children and grandchildren can continue to born safely at home, depends our future as midwives and the future generations to come.

The International Day of the Midwife is on August 31, we should united in defense of our profession.

We should stop this collectively, once it come true it will be very difficult to reverse.

Thanks to spread this among all your contacts, especially to all midwives, women and politicians of our country.

A hug from my heart to any and all who dream of a better world.

SYLVIA

nacermejoruruguay@gmail.com

nacermejorsylvia@adinet.com.uy

See: http://www.elobservador.com.uy/noticia/230121/parir-en-casa

World Breastfeeding Week in Uruguay

2012-08-03T06:13:00.000-07:00

These days we are celebrating The World Breastfeeding Week. In Uruguay, this movement gained strength in recent years, number of organizations have held activities across the country.
Let me show you pictures of activities in the square "Liber Seregni". This place is very significant in montevideo, as it is in a very populous and central location.
It was organized by the public health service, and supported by institutions such as La Leche League, theater schools, libraries, etc..
They showed videos, gave lectures, plays, and various activities that strengthened the importance of breastfeeding.

The right to choose the place of birth

2012-07-23T19:35:00.002-07:00

The latest figures published about maternal mortality are good news in Uruguay, as the number is almost null. But I wonder what price women are paying to sustain these numbers.

Obviously we are the stakeholders in this. However, we also have the right to choose where and how to give birth in safe conditions. In Uruguay, 99% of births take place in medical institution, and in certain maternity cesarean rates are as high as 80% (The WHO suggests no more than 15%).

It seems clear that the price of such a low rate of mortality is based on institutional deliveries and interventions. But I wonder, could it be possible to humanize birth and maintain these rates? Why the Public Health Ministry did not enable the first birth center in the country founded in 2011? Which provided free care to most of the population, placing birth within the first levels of care (ie,

very low cost, to a level of prevention and not pathology). To lear more about “Centro de Maternidad Montevideo": http://www.institutoperinatal.org.uy/es/cmm/default.aspx

INFANT MORTALITY RATE INCREASED IN 2011

2012-07-02T15:23:00.000-07:00

Infant mortality rate increased to 8.93 per thousand in 2011, according to the Pan American Health Organization.
"The slight increase in the IMR 2011 compared to other years is at the expense of the mortality of children under 7 days old, early neonatal, and particularly in premature infants," said the Director of Public Health, Yamandú Bermudez.
Bermudez noted that "post-neonatal mortality (children between 28 and 364 days old), classically associated with public policy, continues to decline."
The causes of the increase are explained by the "improvements in the birth registration system (...) as well as changes in the management of pregnancy (early pregnancy termination to safeguard the life of the mother), said Bermudez.
Walter Perez, president of the Uruguayan Society of Pediatrics, found that two phenomena that are worsening and are likely to impact on this increase are premature (often linked to lack of controls during pregnancy) and respiratory infections (most associated with housing conditions, overcrowding and humidity).

Source: http://www.montevideo.com.uy/notnoticias_171185_1.html
http://www.lr21.com.uy/salud/1046374-triste-regresion-aumenta-la-mortalidad-infantil-en-uruguay-tras-seis-anos-de-decrecer

Triplet birth: At the end there were 3!

2012-06-16T19:57:00.001-07:00

Translation of: Parto de trillizos: ¡Al final fueron tres! de MundoBebe

"This is a history of disagreements between nature and technology starting on Thursday May 6, 1999 at 6 and 30 am, at the Hospital Alvariza of the city of San Carlos. (Uruguay)

I was in the guard room when the nurse tells me that a pregnant woman, Alicia Diaz, carrying twins, was consulting by contractions.

I immediately went to the clinic where the patient tells me she had been with irregular contractions all night. That morning she had to pick up an abdominal x-ray that the doctor had ordered, since they didn’t know if she was 32 or 36 weeks of gestation. There was no coincidence between the date of her LMP and the ultrasound, so the x-ray would determine the gestational age of the infants.

Alicia spoke quietly and slowly, without hiding the discomfort caused by contractions.

I proceeded to do the pelvic examination, and for my surprise I see that the dilation was complete and my fingers touched a tiny foot ...

I called by phone the gynecologist and pediatrician, while we move the lady to the delivery room.

At 7.20 John was born weighing 2000 g., At 7.30 Gustavo was born weighing 2400 g. Both were born in the footling breech position (Feet came first).

We performed the Capurro test to confirm gestational age, which was 36 weeks.

The delivery room was full with joy and laughter as everything had gone well: children enjoyed great vitality and the mother was happy with her two boys. As everything had passed so quickly, neither the gynecologist nor the pediatrician arrived in time for delivery. After attending both births I got ready to attend the delivery of the placenta.

When I examine the lady, I am struck by the size of her remaining stomach, and this time my fingers hit a head...

"There is another one" is what I managed to say. Immediately the reactions of those who were in the delivery room were most diverse: the nurses thought it was a joke, the mother asked for an ultrasound...

A few minutes later Alfredo pocked his head as if to ask why the fuss.

He had mocked ultrasound unwilling to show himself until the last minute. He was as vital as his brothers and weighed 2050 grams.

I wanted to share with you this life experience, unforgettable for all who were there and meditate about the wisdom of nature. Sometimes we do not let her take her course for our lack of patience.

I thank the nurses who assisted the birth, and a special thanks to Alicia, her calm eyes and unhurried voice gave me the opportunity to help her bring three babies to this world."

Elizabeth Hegedus

Midwife

Born at 27 weeks and survived

2012-05-31T19:18:00.001-07:00

Maia is the first baby in Uruguay, who survived at only 27 weeks of gestation. She was born with only 460 grams and 30 cm long, in an ambulance, while her mother of 18, was transferred from the Department of “Durazno” to a maternity in “Montevideo”.

She was hospitalized for almost three months, and doctors suggested that parents apply the Kangaroo Mother Care (KMC) Method (http://www.kangaroomothercare.com/). This method has three pillars: Skin to skin contact, exclusive breastfeeding, and support the dyad mother-baby without separating them.

Three months later and two kilos of weight Maia is with his family in “Durazno”, breathing by herself, and starting breastfeeding by suction

"It wasn´t nice to live but thank God the baby is divine, everything went well," the girl's father told.

If you want to read more: Subrayado, ElAcontecer

The story of a pregnant stowaway

2012-05-29T13:06:00.000-07:00

Israel Onugha came to Uruguay about 5 years ago as a stowaway on a ship that left Nigeria with four other Nigerians. At that time he was just 18. He dreamed of a better future and study somewhere where they have better opportunities than Nigeria. They were discovered at sea and delivered to the authorities in Montevideo, where the ship finally made port. At that time, shelters and social organizations managed to start the process of residence, which he never ended.Sally Arewa left Nigeria about three years ago, she was suffering religious persecution because she had converted to Catholicism. She managed to raise some money for the plane ticket and came to Uruguay as a tourist. Of course, undocumented, without work, without knowing the language and without any reference contact.Soon after they met in Montevideo, she realized she was pregnant. Very frustrated they went to Brazil looking forward for a better job, and thinking that in a much larger country they would be luckier.
In Brazil, everything got worse. None of the two had documents and so they were unable to find work or housing. They had a long time of great difficulty and poor feeding. Sadly their baby died shortly after birth.Soon they discovered she was pregnant again and decided to return to Uruguay. But since they arrived nothing has been easy.They went for birth control and met Sylvia, a midwife from "NacerMejor". This is how this story came to light.One of the times they went for birth control, Sylvia found out they had been eaten just bread and water for 3 days.

Every effort is being made to help them get residence papers, so they could use social benefits. Right now every help is welcome.

You can learn more of Sally and Israel situation on NacerMejor Facebook.