http://www.ourbodiesourblog.org/blog/2008/01/update-on-afghan-maternity-hospital Daily dose of women's health news and media analysis Wed, 08 Feb 2012 16:46:25 +0000 hourly 1 http://wordpress.org/?v=3.0.1 http://www.ourbodiesourblog.org/blog/2008/01/update-on-afghan-maternity-hospital/comment-page-1#comment-327 Deanne Williams Thu, 03 Jan 2008 17:51:02 +0000 http://ourbodies.s467.sureserver.com/?p=435#comment-327 It is risky to comment from the privileged settings where most of us give birth so I want to start by acknowledging just how hard it is to be successful in these difficult conditions. But when you train obstetricians to be surgeons first, when OB residency programs give little or no opportunity to learn how to manage labor (even complicated labor) in a way that promotes a vaginal birth, and many MDs believe (in spite of the evidence) that c-section is always safer than vaginal birth, this result is predictable. Sadly, we cannot export our women's healthcare system and expect to improve the health status of women in the high need countries especially where gender of the provider matters. I know that nurse-midwives from several countries have been involved with these efforts to reestablish a safe setting for women but often midwives (both local and consultants) are not included in the planning, are treated like servants and/or are pushed into a medical model of care. The reality is that without well educated and empowered midwives as partners in the planning and implementation and a system to educate more in the future, the outcomes will not change. It is risky to comment from the privileged settings where most of us give birth so I want to start by acknowledging just how hard it is to be successful in these difficult conditions. But when you train obstetricians to be surgeons first, when OB residency programs give little or no opportunity to learn how to manage labor (even complicated labor) in a way that promotes a vaginal birth, and many MDs believe (in spite of the evidence) that c-section is always safer than vaginal birth, this result is predictable. Sadly, we cannot export our women’s healthcare system and expect to improve the health status of women in the high need countries especially where gender of the provider matters. I know that nurse-midwives from several countries have been involved with these efforts to reestablish a safe setting for women but often midwives (both local and consultants) are not included in the planning, are treated like servants and/or are pushed into a medical model of care. The reality is that without well educated and empowered midwives as partners in the planning and implementation and a system to educate more in the future, the outcomes will not change.

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