Chapter 2: Treating health problems
Know your limits
Know when to do nothing
In this book, we talk mostly about how to solve health problems. This is
important. But in many cases, the best thing to do for a woman in labor is
nothing! A woman who is healthy is likely to have a healthy and happy birth.
Most births go well.
Doing unnecessary procedures can cause serious problems. Respect the process
of birth. When all is going well, simply watch and wait.
Know when to get help
No matter how skilled you are, there will be times when you need help. Knowing
when to get medical advice, when to enlist the support of another midwife, or
when to send a woman to a doctor or medical center, is a skill that every midwife
must try to master.
It can be hard to know when to get medical help.
Hospitals and medical centers are often expensive or far
away. Many women are afraid to go to them. A woman with
a small problem may want to stay home. She may not want
to go to a medical center unnecessarily. But if she stays at
home without help, the problem could get much worse.
If you know a woman is having a problem like
hemorrhage, infection, or pre-eclampsia, do not delay —
get medical help. The sooner you go, the better her chances
of recovery. Sometimes you may have to rush, sometimes
you may not. If labor is long, for example, and you live and
work very far from a medical center, you must start your
journey early, before the problem is serious. If the medical
center is only across the road, you have more time.
Deciding when to get
help can be difficult.
When in doubt —
get medical help.
Know when to take action at home
Midwives who work very far from medical care must also sometimes give
treatments that are better done in a medical center or hospital — because the
woman needs the treatment right away. For example, if a woman in an isolated
village has a seizure from eclampsia, her midwife should give her magnesium
sulfate, a drug that is not usually
safe to give at home. Then the
midwife should take the woman
to a medical center right away,
because both the seizure and the
magnesium sulfate are very
A Book for Midwives (2010)