Getting priorities right second time

// 15 September 2009

Via Radical Doula, the New York Times ran an interesting piece about a clinic in Peru, which was forced to change how it operated because so few women were choosing to give birth there.

That is, in 1999, only 6% of births in the Santillana district of the Ayacucho region, took place at the clinic, although the area had one of the highest death rates in pregnancy and childbirth in Peru.

When the health workers actually asked women in the area why they weren’t using the service, they found out:

Workers at the clinic did not speak the local language, Quechua. They treated patients brusquely, and barred husbands and other relatives from the delivery room. They forced women to wear hospital gowns instead of their own clothes, and made them give birth lying on a table instead of squatting. They threw away the placenta instead of giving it to the family to bury in a warm place.

Working with local people, members of a nongovernmental group, Health Unlimited, changed delivery services at a clinic in the Santillana district. They made sure Quechua was spoken, let relatives stay and help, set up delivery rooms so that women could squat and made other changes based on local traditions.

By 2007, 83 percent of births were taking place at the clinic. In a report in this month’s Bulletin of the World Health Organization, the authors say that the project in Ayacucho shows that indigenous women with little formal education want professional help giving birth, and will use it if they are treated with respect at clinics.

This short report by Amnesty International includes a small section on what happened at the clinic, too, including this quote from a woman in the area:

“Before, they used to take them to a room, shut the door and not let their families in. They did not have the rope or the chair as they do today, but were made to lie on a bed with their legs open; they were shouted at and they did not like that, they were attended to in a noisy, laughing, manner and they did not like that either.”

“Now they treat us in the way we like, whether in bed or sitting on the chair, holding onto the rope. Our husbands put their arms around our waist and we like that; because that’s what we are used to on the farm. We would like it to continue like this, boiling herbs, making household remedies just like at home.”

As Radical Doula says:

Why are we building clinics and funding initiatives that have women’s desires and needs as an afterthought? Maybe stories like these will start to change the paradigm, cause the current model really sucks.

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