Tough Talk: Abuse During Childbirth

hello and welcome to Top talk from the women deliver 2016 conference in Copenhagen I'm Andrea Sankey and with me now is Amelia Christmas she's an obstetric and neonatal simulation specialist based in Bihar India now in simpler terms but no less impressive she is a midwife and we're talking to her today about abuse during childbirth and that may sound a very foreign topic too many of you watching but to too many others it is a terrifying and sometimes life-threatening reality Amelia fights to ensure safe and respectful care for women as they fight to bring our next generation into the world Amelia thanks so much for joining us begin if you will by painting the picture for us and describe how you saw being babies deliver deliver that made you realize there's a serious problem here to tell some of my experiences in terms of how the deliver babies mostly the technical knowledge for our midwives and Bihar is very less because it has been more of a traditional thing to do at homes rather than at hospitals so they just do it as normally as possible and when something wrong happens they really are not aware of how to handle it so there's a serious issue with a lack of proper training yes there's a serious issue with that with a lot of nurses have not really undergone a proper training at all who have been practicing all these days they have just some of them have just got it traditionally over you know through families the grandmothers someone has been doing so they feel themselves as fit to contact to you know do deliver or conduct birds but actually they are not really undergoing training and in some cases there's even corruption involved whereby they by qualification certificates without being trained yes yes because of the poor training there because of them not having actually any standards they automatically people go to do all these things and they just tend to you know by qualifications or say that they are actually are turning our training but actually already started practicing and that's how they do it and another of the arguably more disturbing aspects though is the indifference of these midwives and nurses and the verbal abuse that they will actually hurl at their patients to the point that the experience of childbirth becomes deeply disturbing and can affect women and their babies in the long term tell us about that yes so what or if you see is how the midwives look at childbirth is because they look at it as a normal thing they think that there should not be much fuss about it they feel that everything should go as normally as any you know anything else right so when there is a lot of fuss they get very upset and there is not adequate counseling again with the same notion that it's normal and you don't have to really make a fuss and one more thing is why this cold is because sometimes in our community it is considered that health care providers have an upper hand than the patients the patients look up to health care providers hoping to get all that is possible you know that they know better than us so they tend to depend on them a lot while the health care providers always feel they have a half per hand and so they feel that when they have the right intention it is okay to scold it's okay to talk a little rudely mostly with a thing that we have the right intention for the patient that ultimately they the end will justify the means somehow but still you want to change their indifference towards these patients yes how do you make them care so we we are trying to help them explain to them that kind and respectful care takes a big lead in order for the patients to recognize hospital care like most of our deliveries happen at home most of our deaths happen at home because the patients leave the hospital within two hours of delivery thinking that they do not need that extra care but most of our deaths unfortunately happen at home and in order to keep them back of the facility and make sure that they get the required care we need to be kind and we need to make sure our care is friendly and in be trained nurses in all the government facilities so we train them in very simple aspects of how to speak kindly with a good tone and specially listening to the patient's concerned the listening call component is completely absent because always with the midwives tend to think that they have a upper hand so you know how to listen to the patient and how to not blame her for all her cum all her problems often times we have patients both mothers and babies coming at a very large stage to us you know if they have bleeding del comet shocked at the stage of shock or they should have given some medicine in the village and come with uterine rupture or they should have given the baby some other things other than breast milk and they'll come with you know enteritis and shock so we always get patients in the last stage so that kind of makes nurses very appearance and scold them and blame them but sometimes we realize that when we tend to blame them that way they might not come back to us at all if your letters will not come back to us so we try to help them understand that if if we want patients to seek us to seek our care we need to be kind we need to be friendly and we need to help them understand and rather counsel them instead of blaming them you know ahead of time because if you don't do that ultimately the baby's life is at risk and the woman's life can be at risk to not just her life but her self-esteem yes yes yeah so what happens is when we have discussed with the community asking them what do they really expect because of this whole cultural thing sometimes the expectations of patients become very less like our nurses used to tell us ah she doesn't expect what you are seeing you know so actually the expectation around health care itself reduced a lot in our community so helping them realize that they deserve good care and they they they will receive friendly and respectful care is also a huge different task you know to help the community understand what they deserve to get and yeah I think that is a whole do that is a whole different concept yeah okay Amelia unfortunately we're going to have to leave it there i'd like to thank you so much for joining us and sharing your insight and thank you for joining us for this women deliver tough talk you can tweet your comments and questions about this and our other shows using the hashtag WD live

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