Why 'Women and Children First' matters.
Hypnobirthing is all about preparing mums-to-be for a smooth, comfortable natural labour. It’s about approaching birth as natural by default, with medical intervention if needed; not the other way round.
But aren’t we lucky to have access to first rate healthcare if we need it?!
I was born and bred in London and have never taken the NHS for granted. Not when I had a kidney removed... or during my pregnancies... miscarriages... cervical stitch when pregnant with iris... my two labours... phew! Thank you NHS!
Despite this, or perhaps because of it, lets not forget the others who are far less fortunate. Women in developing countries, for whom pregnancy and childbirth pose a danger to them or their baby. Motherhood should be an optimistic and positive time, not a time to be feared.
So, I donate 10% of each course fee I receive to charities transforming the lives of women in need, in pregnancy and birth. In this way, Hypnobirthing Place parents and I are spreading the good of a positive experience. Simple.
Here is a short and inspiring interview with Ros Davies, the chief exec of Women and Children First (WCF), one of the two charities I support.
WCF are celebrating 15 years of supporting women through pregnancy, birth and beyond. I met Ros for a coffee and a chat in Kings Cross and came away thinking what a marvellous woman she is and how much better the world is with people like her in it.
How did Women and Children First come into being?
Ros. Our founder trustee was Professor Anthony Costello who at the time headed up one of the departments at UCL’s Institute of Child Health. He set up WCF because he and his colleagues had been looking at persistent high rates of newborn deaths globally and wanted to understand which interventions would help.
Information is not enough…
He knew there were lots of traditional communication programmes which had told women what to do, but despite this, they didn’t do it; e.g. not looking after themselves well, during pregnancy, still delivering with traditional birth attendants using unsafe practices, in places where hygiene was poor. They still weren’t aware of danger signs in pregnancy and childbirth for themselves or in their newborn baby.
Anthony became aware of a small research project that had been carried out in Bolivia through Save the Children. They had brought women together to talk in their peer group about these issues. This was participatory, talking with rather than at the women. It seemed to have a positive effect on their behaviour. So Anthony set up a field trial in Nepal. That first trial, reported in 2002, showed a very significant reduction in maternal mortality rates of 69%, and a 30% reduction in newborn mortality rates.
The community of maternal child health academics and professionals who were more traditional said this was rubbish (to paraphrase!).
Their argument was you have to change the whole health system, engage more medical professionals and equip them with all the right equipment and drugs. So Anthony said fine, let’s do it again. So trials were repeated in India, Bangladesh and Malawi. A rigorous meta-analysis of seven field trials was done which concluded that in the right circumstances, where there is high rate of maternal and newborn mortality and in very rural areas, this participatory approach is effective for saving mothers’ and babies’ lives.
What values or beliefs drive what you do and how you do things?
Ros. We believe everybody deserves to be treated equally and to have access to quality information and services to safeguard their health, especially in areas of high inequality (limited access to services, low economic, education or health status).
Our work has a rights based approach, it’s about people realising what their rights are and being empowered to act on them.
Women can be very badly treated in health facilities – they might be shouted at or slapped if they make a noise in labour. They can be waiting for hours to see a doctor or midwife. These women can be quite meek, they say ‘we didn’t know we were entitled to free vaccinations’. In Malawi they still say that a pregnant woman has one foot in the grave.
These women need more information and access to quality health services.
Women’s groups empower women to know what to expect and to be able to voice it, either themselves or through a village chief or community health worker who will advocate on their behalf.
How do your projects work to make a difference?
Ros. Women and Children First use WHO (World Health Organisation) statistics to choose countries in greatest need – i.e. those with the highest maternal newborn death rates, high levels of poverty and high numbers of people living in rural areas. Mainly sub-saharan Africa and some countries in Asia (Nepal, India and Bangladesh). We work for long-term beneficial changes, not emergencies, so we don’t work in countries which are very unstable. But political instability can arise at any time and they are likely to be suffering from catastrophic effects of climate change such as drought or floods.
We work with existing local organisations such as the MaiKhanda (Mother/Baby) Trust in Malawi or Amref Health Africa in Uganda. We train the organisations to run women’s groups in the local community, using a curriculum developed in collaboration with WHO and UNICEF.
There are around 25 women in a group and they meet once a month for 18 months. They have the following phases:
- First, they talk about problems encountered in pregnancy, childbirth and the newborn period.. Distance from health facility, lack of food and lack of money and things they need when giving birth, like plastic sheets, bowls and baby clothes, but may not have the money to get.
- Then the group picks the top 5 problems and devises strategies to overcome those challenges. So if it’s distance from a health facility, they might set up stretcher schemes to carry women down mountains or save to buy a bicycle ambulance.. If there’s a problem with malaria, they set up a bed-net committee to get treated bed nets and ensure people use them. It might be mobilising what’s available from the local community or lobbying local NGOs and funding bodies.
- At the end, they self evaluate what they’ve been doing, and refine their strategies. It remains sustainable after a project has ended, after external support has finished. The glue which helps stick this together is often the village fund, which they might keep going by selling things they’ve made or crops they’ve grown. As long as there is a fund, that keeps getting loaned out and replenished, they don’t have to rely on continued donations.
Tell me about a memorable moment
Ros. I was on a visit to India and met a woman who had been in her local women’s group, but at a certain point she got pregnant and left the group.
The other members of the group knew her home situation was difficult and kept an eye on her. She lived in her husband’s mothers house, and the mother-in-law would only allow her bread and water. The women’s group knew that she wasn’t looking very well and when she went into labour it was prolonged, so they asked the local community health worker to go ask the husband and mother in law to take her to the local hospital.
It turned out, the woman who was giving birth had preeclampsia. They took her to the local clinic, the local clinic couldn’t help her, she was too sick, but they got her an ambulance to the local hospital where she was given a caesarean. If the women’s group hadn’t intervened, the woman and baby would have died. Instead, she survived. And she had a lovely baby after all that!
What do you hope to achieve next through Women and Children First?
Ros. We know it works because we have the scientific evidence from the seven field trials). We’ve got a World Health Organisation recommendation too. So now we want to roll it out and scale it up to national level in some of the countries where we work, so that across the country there is this provision. That’s our ambition.
How can The Hypnobirthing Place best help?
Ros. Continuing to provide funding as well as raise awareness.
I am doing my best, and I need your support. If you are pregnant, joining one of my courses will mean you can prepare in the best possible way for birth and parenthood, whilst helping this wonderful charity too. If you are not pregnant, but are inspired by this story, please feel free to spread the word about Hypnobirthing Place. To donate directly to Women and Children First, please click here.
 I’ve just looked Prof Anthony Costello up on Wikipedia – he’s now Director of the Department of Maternal, Child and Adolescent Health at the World Health Organisation. He must be pretty amazing.