Questions in a pregnancy health history
A community transport plan should address all the reasons for delays in
getting medical help. To understand these reasons, talk to other midwives who
have lost mothers or babies during labor or birth. Talk to families who lost a baby
or a mother too. Ask about when the midwife or family first
knew there was a problem,
and how long it took them to
get help. Find out why the
Mariama, you lost
3 women last year.
Do you know why?
More women die in
storm season, when
the road is flooded.
midwife and family did not go
for help sooner. If possible,
these families could meet and
all talk to each other. Invite
community leaders to listen
to what these families and
midwives have to say.
A midwife or a family might delay getting emergency care for many reasons:
• The woman, family, or neighbors may feel that the husband or another
family member must give permission for the woman to get care.
• The midwife may feel afraid that people at the medical center will blame her
for causing the problem.
• The family or the midwife may feel there is no hope — that going to
a medical center will not help.
• The family may not have money.
• There may be no car, truck, or other transportation.
After naming the reasons why families in the community do not get help, find
solutions. You may be able to find a solution within the family. If the husband
must give permission for the woman to go to the hospital, he can give permission
in advance of the birth in case he is not home. Some problems are best solved by
the whole community. In some villages, every family contributes a small amount
of money every year. Anyone in the community who needs medical help can use
the pool of money to pay for transportation to
a medical center in an emergency.
If everyone understands the
problems that women in
labor face, they can work
together to help women get
medical care. By talking to
families and communities
about the need for emergency
medical care, you can help them
make a plan that works.
A Book for Midwives (2010)