Chapter 2: Treating health problems
Finding the best treatment
When you treat any health problem, from anemia to too-long labor
to heavy bleeding, you must find the treatment that has the
most benefits and the least risk of harm.
Benefits and risks
Any time you make a decision about a medical
treatment, you should consider the benefits and
A benefit is the good that an action or
treatment might bring. A risk is the harm that it
might cause. Each time you make a decision, try
to choose the action with the most benefit and
the least risk.
Think again about Elena and Celeste:
What if Elena’s anemia did not go away after eating
more iron-rich foods and taking iron pills? She and
Celeste would have to make a difficult decision.
When the benefits “weigh”
more than the risks, an
action is worth doing.
Celeste knows that a woman with severe anemia is probably safer giving birth
in a well-equipped medical center than at home. This way, if severe bleeding
happens, a blood transfusion is immediately available. Without this care, Elena
might be very weak after the birth. This weakness will make her more likely to get
an infection. It will make it very hard for her to care for her family and herself. And
if a baby’s mother is not able to care for him well, he may be in danger too.
On the other hand, most women in the village have anemia. And most of them
will not have serious problems after their births. The hospital is a day’s journey
away and very expensive. Elena’s family would have to spend most or all of their
money for her to give birth there.
Staying home and going to the hospital each have benefits and risks. What
would you do?
Medicines in particular have both benefits and risks. Even a medicine that is
very helpful for treating a health problem may have side effects or dangers. In this
book, there are procedures and medicines that have very serious risks. We include
them because when they are truly necessary, they can save lives. But before giving
any medicine or doing any invasive (inside the body) procedure, including
emergency procedures like removing the placenta by hand (page 230) or MVA
(page 416), you must decide if you can do it safely — with more benefit than risk.
A Book for Midwives (2010)