Avoiding Maternal and Infant Deaths



The other day a lovely young lady asked to meet me at one of my favourite coffee shops here in Oaxaca, Mexico. As I ate my salad and she sipped her fruit smoothie, Luz introduced herself and her mission. Having finished her Master’s degree, she is now hoping to address the issue of relatively high rates of maternal and infant mortality here in Oaxaca. Somehow her path led her to the door of Casa Compasiva and she sought me out for an interview. How do we at Casa Compasiva work to prevent maternal and infant deaths? How indeed?

I explained that the hallmark of our maternity care is education. While few doctors or health centers in Oaxaca make much of an effort to educate their patients, Casa Compasiva distinguishes itself by supplying educational materials at each and every pre-natal appointment. We also provide a book to each client: Preparandose para la Llegada de Tu Bebe. (Thank you to Prepared Childbirth—The Family Way-- for permission to use their excellent resource in Spanish!)

However, we recognize that Oaxaca is largely an oral culture and that not every woman has the literacy skills to be able to wade through written materials in order to glean helpful information. Not content to leave anything to chance, for that reason we also have a series of eight interactive childbirth education classes that our clients are obligated to attend. (If they come to us late in the pregnancy, they just attend as many as they can fit in before baby arrives.) These classes cover the process of birth and overcoming fear, benefits of a natural birth (as opposed to an elective Caesarean), how to avoid unnecessary interventions, stages of labour, nutrition, exercise and relaxation for birth, breast-feeding, care of the newborn, etc. Everything from soup to nuts basically, and all of which helps women to understand their bodies and to distinguish between normal symptoms and those that are cause for concern-- a huge step towards reducing mortality rates!

By this time in the interview, my new young friend was visibly impressed by the extent of education that we consider essential in order for our pregnant mamas to make informed decisions about their care. Again, in her mind she was contrasting our approach with the typical care available at other institutions in Oaxaca.

As I went on to talk about our professional midwifery care and that we follow scientific, evidence-based practices, not old-wives’ tales or superstitious traditions, she nodded enthusiastically. Additionally, I explained, Casa Compasiva midwives have a luxury seldom available to busy doctors in over-crowded clinics—that of being able to devote concentrated time to each pregnant woman under their care. Rather than the average 12-15 minutes of medical attention in the standard routine office visit to their doctor, pregnant women who come to Casa can expect a good hour of thorough pre-natal care with every appointment. This goes a long way towards screening for complications and ensuring that mamas are well-prepared for the rigours of birth—physically, emotionally, and spiritually.

My family arrived and was waiting for me in the car outside the coffee shop, so I hurried to finish a few more key points for Luz to understand. At Casa Compasiva, we practice continuous monitoring of women in labour--taking BP and fetal heart tones at regular intervals. We provide doulas to assist the women to labour in greater comfort and confidence. We are fanatical about excellent post-partum care and follow-up, and lactation consulting. And-- very importantly—we humbly recognize the limitations of midwifery care, and are careful to consult with specialists or to transport (if needed) for complications that might arise. Concluding the interview with a hug and an invitation to come and tour our facilities, I reiterated to Luz that all of these safe childbirth principles that we follow help us to prevent maternal and infant deaths at Casa Compasiva.

Sadly, because I had to run, I did not have time to tell Luz about perhaps the most important factor that helps us in our task -- prayer. Plain and simple. We do not depend on our knowledge or our abilities as we care for these precious women of Oaxaca. We depend on Almighty God, and we cry out to Him for wisdom in every aspect of the pre-natal, birth, and port-partum care that we provide. I hope that when next I meet Luz I will have the chance to tell her that!

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