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To achieve this reduction of maternal death we have to strengthen traditional midwives and those who already have a technical background. The latter is on the jobs list in the Ministry of Health ( Secretaria de Salud SSA) and there is money to hire 32 people with this training, but we need to intensify the development of human resources, said Nadine Goodman, founder of the CASA, the only school of midwives in the country.
She noted that only Chiapas, Guerrero and Veracruz are committed to the creation of such schools and that they are in the process of solidifying agreements of cooperation to duplicate the CASA’s model. However, she warned the specialist, it requires much more to have at least one professional midwife work in each of these 100,000 poorly developed communities in the country.
And, she said, none of the actions taken by the government have managed to bring down the maternal death rates from causes related to pregnancy, childbirth and postpartum. So, while decreases were reported, the number of deaths is high.
Official information indicates that the maternal death rate in 2010 stood at 49.5 per 100,000 live births, the millennium goal by Mexico is committed to lower it to 22 per 100 000 by 2015. The SSA has recognized on several occasions that it will not be possible to achieve this goal. The previous official program acknowledges the gaps in health services, such as lack of medicines and poor training of doctors and nurses in addressing obstetric emergencies. Another problem is the difficulty women face in reaching the hospitals. It is an issue with several facets to attend. Isolated actions have had only partial success.
CASA’s experience has shown that it is possible to achieve better results with midwives working in primary care. The non-profits’s hospital and school of profesional midwifery is located in San Miguel de Allende, Guanajuato, and during the period 2002 to 2005 there were five maternal deaths in the municipality, none at CASA, while in the state 58 women died.
Providing prenatal care that midwives give to to pregnant women also helps reduce the number of cesareans. In the period indicated, the hospital of CASA reported 13 percent of surgeries of this type, while statewide the rate was 35 percent.
Another aspect that realizes the benefits of the care provided by midwives is the decrease in low birth weight babies. At CASA there was 4.6 percent between 2002 and 2005, while in Guanajuato was 10.9 percent. The low birth weight puts at risk the lives of the newborn.
The recognition of the value midwives bring led the SSA to recognize the the CASA’s work and even CASA’s hospital was accredited by the Popular Insurance, is part of the service network for affiliates to the scheme.
In March 2011, the SSA approved the inclusion of the professional midwife with technical level positions in their job offerings, so resources were allocated to hire 32 such professionals. To date we have held around 20 people. What is missing, Goodman said, is to strengthen the preparation of human resources. This requires the involvement and commitment of the state and federal authorities.
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