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LE SOLEIL - marDI 3 juIN

Humanized Childbirth: Comfort Measures for Childbirth

Senegalese women have been accustomed to giving birth on
delivery tables with limited movement, but now they have
another option of delivering babies. They are called freestyle
deliveries, and they let them be in the position of their choice. In
addition, they can be assisted by a close relative. Interviewed mothers
welcomed the initiative, because they felt as though they were in
their own homes.

Report prepared by Mamouna GUEYE

and a midwife, explains Dr Diagne

to approximately twenty journalists
from nine French-speaking West
African countries during training
sessions in Dakar, in the context of
the Ouagadougou partnership. This

initiative plans on recruiting one

million new family planning users
by 2015, aiming to ensure that
women living in these nine States
have access to services, products,
and quality information on
contraception.

Standing, sitting, squatting, laying

down. Now, if they desire, Senegalese
women may choose from these positions
during childbirth. This fits in the
promotion of freestyle childbirths which
is an integral part of humanized childbirth.
It is a major component of
maternal and neonatal health care
(Pressmn), a project initiated by the
Ministry of Health and Social Action of
Senegal, in collaboration with Jica
(Japanese cooperation agency).

in March, 2014 in Gaspard Camara's

health center of Dakar, selected among
the different sites to help spread
natural childbirth methods.
We realized
that women were scared of delivery
rooms because of the terrible
treatment. This explained the high
number of registered home deliveries.

The goal is to fight against maternal

and neonatal death rates. It is also for
this reason that the eastern regions
(Tambacounda and Kedougou), which have
the highest rates of maternal deaths in
Senegal, have been selected to test this
strategy between 2009 and 2011.
Since the tests were successful,
humanized
childbirths
were
introduced

We needed to make improvements by

implementing humanized childbirth,
especially since during labor, women
want to be in positions that help ease
the pain said Dr. Sehrish Diagne,
gynecologist at Gaspard Camara.
According to her, with free style
deliveries, the mothers are the focal
point. The provider adapts to them and
provides all the support they need
throughout the process. In addition to
choosing their own positions, and
contrary to traditional births on a
table, women may be assisted by a
close relative,

With humanized childbirth, the services, which were the weak link in the health
care system, have been considerably improved.
Providing comfort to
laboring mothers
For the Gaspard Camara health
centers gynecologist: when a woman
wants to give birth on the floor, for
example, there are mattresses
available.

Because, these new rooms have been

furnished to accommodate humanized
childbirths, they are equipped with
tatamis which serve as mattresses. There
are also swings, birthing balls, and
cushions. Everything to ensure the
mothers comfort during childbirth.
And they usually choose to give birth
standing, sitting, squatting or lying
during the first prenatal visit, adds Dr
Diagne.
The Deputy Surgeon General of the
district Dr. Rokhaya Sy, specifies that
all women who come to deliver are
received in a triage room. We conduct
an assessment to see if they can have
a free style delivery by choosing the

position of their choice he says,

stressing that regardless of the
position that will be chosen, they will
be supported. Maary Sow chose to
give birth on the floor, on a mattress.
Simply, because it's what I know.
Even though I am currently in
Dakar, its what they do here in
Fouta, she says. Having also chosen
to deliver her baby on a mattress
placed on the floor, Ndye Amy Sow,
whose mother-in-law assisted her, on
the afternoon of Wednesday, May 28,
2014, demonstrated that she is more
at ease in this position, than on a
table on which you cant move

adds Mame Yacine Diaw, another

mother.
Gynecologist, Ndye Awa
Diagne, specifies that movements
are limited on a table. Thus,
childbirth feels like a punishment,
whereas when we listen the bodys
natural needs, women can take any
position they want. Dr Diagne, adds
that with the presence of a loved one,
the atmosphere is more relaxed, which
makes labor progress faster. But when
it stalls, women get impatient.
Therefore, freestyle childbirth helps
prevent stress, obstructed labor, etc.

A pain relief method

Comparing her recent freestyle
delivery, to her first, Ndye Amy Sow
admits that she did not have any pain
this time around. Unlike her first
delivery which was followed by a lot
of back pain.
For Dr. Rokhaya Sy, Deputy
Surgeon General of the Dakar Central
Health District, natural methods are
used to avoid pain during labor. For
instance, massaging mothers backs
while they are in labor helps relieve
pain, and relax them she revealed,
and then emphasiz other actions

Mothers helped by relatives and medical personnel, now receive more

attention and support during childbirth.

that mothers benefit from at the

Gaspard Camara health center. We
also help them walk, drink, etc.
assures Dr. Sy who thinks that
although
painless
childbirths
generally have a cost associated with
them, that is not the case for natural
methods which is an inexpensive
strategy. What is recommended with
the method of humanized childbirth
is not to spend a lot of resources, she
adds.

Moreover, the Deputy Surgeon

General of the Central District says
that
we stopped many unnecessary
procedures which were performed
during traditional childbirths. In the
same train of thought, Dr. Ndiaye Maguette Ndiaye, Surgeon General of the
Central Health District says, drugs to
accelerate labor (perfusions) were
used without any basis in scientific
experiments.

DR. NDEYE MAGUETTE NDIAYE,

SURGEON GENERAL OF THE CENTRAL
DISTRICT

Free-style applied only in the case of

normal birth

The Gaspard Camara health center

records approximately 400 births each month. Between March and May
2014, 41 women chose freestyle childbirths. Simply because only normal childbirths can be
freestyle, informs Dr. Rokhaya Sy, Deputy Surgeon General of the Central Health District.
According to her, if there is a risk, then the traditional delivery table method is whats used.
Therefore, in the event of complications, they cannot perform a freestyle delivery. In the event
of bleeding, for example, we
cannot perform a freestyle delivery. Women who have a narrowed pelvis cannot use natural
methods, adds Dr. Sy who specifies that it is the same for those who have already undergone an
operation.
Dr. Ndye Awa Diagne added that only 41 women have had this style of delivery, because they do
not have all of the information. In fact, we didnt even expect that amount, because this
method is not well known, yet she says.
To raise awareness, and gain acceptability of freestyle-natural childbirth methods, aside
from the help of the Badianou Gokh, we are also planning on training representatives
and local associations so they can raise awareness, informed gynecologist Ndye Awa
Diagne. Dr Diagne maintains that there were fewer complications with freestyle births
compared to traditional births.

No Work Overload

LE SOLEIL - marDI 3 juIN

Health care providers supporting the mothers feared that they would be overloaded
with work. That was the first thing we were afraid of, said Dr. Ndye Awa Diagne,
gynecologist. But this method, which focuses on the community is made specifically so
that the midwife can perform other tasks, while the mothers are being assisted by a
relative, as if they were in her own home. The provider only checks in from time to time
to reexamine her, she says.

An Experiment from Japan

Humanized childbirth is an experiment from Japan. Their country has almost no
maternal or neonatal deaths, says Dr. Ndeye Maguette Ndiaye, Surgeon General of
Dakars Central Health District. In addition, according to her, Japan has midwives who
do home deliveries using freestyle methods under the supervision of gynecologists. For
this reason, she said that the initiative tested in Tambacounda and Ke-dougou is the start
of the crusade against maternal and neonatal mortality.

A
Providers receive training in
behavioral change.
Implementing humanized childbirths
was not easy, recognizes Dr Ndye
Maguette Ndiaye , Surgeon General
of Dakars Central Health District.
We had to rearrange our rooms in
order to make more space she says.
Training our personnel was a whole
other story. Because the training had
to lead to a behavioral change. Thats
not an easy thing to do she
explained. Ndye Awa Diagne,
gynecologist adds:
in basic training healthcare providers would only see birthing tables. So if they
accept this method, then it can easily be implemented.
Deputy Surgeon General, Dr Rokhaya Sy, thinks that many of the training
sessions were successful. They had qualified, and non-qualified personnel,
as well as Badianou Gokh or neighborhood godmothers. These women are
respected leaders in their local communities. In that capacity, they help
women g o t o t h e i r p r e n a t a l v i s i t s , d e l i v e r i n s a n i t a r y
conditions, vaccinate their babies, and promote
contraception through birth spacing, which are all actions
that benefit families as well as the entire community. This is
why they are
chosen to assist in humanized childbirths: to help raise awareness and help this
method of freestyle childbirth be accepted by everyone, everywhere.