Thank you! But does it cause a problem? A book for midwives 20 Chapter 2: treating health problems know your limits when you should do nothing in this book, we talk more than anything about how to solve health problems. That’s important. But in many cases, the best way to help a woman in labor is to do nothing! If a woman is healthy, she is likely to have a healthy and happy birth.
Most births go well. You can cause serious problems if you do procedures that are not needed. Respect the process of childbirth. When all goes well, do nothing but watch and wait. When you need help as skilled as you are as a midwife, there will always be situations where you will need help. It is a great skill to know when to get medical advice, when to ask another midwife for support, or when to send a woman to a doctor or hospital. All midwives should try to master that skill.
When to get medical advice
It can be difficult to know when you should get medical help. Hospitals are often expensive or far away. Many women are afraid to go there. If a woman has a small problem, she may want to stay home. But if you stay home alone, the problem could get a lot worse. If you know a woman has a problem such as bleeding, infection, or preeclampsia, don’t delay: get medical help. The sooner you go for help, the more likely the woman will recover. Sometimes, you may need to hurry and sometimes not. If a birth is taking too long, for example, and you live and work far away from a hospital, you will have to get on your way soon, before the problem is serious. If the hospital is around, you’ll have more time.
When to act, at home midwives who work far away from medical services sometimes have to give treatments that are preferable to do in a hospital, because women need them immediately. For example, if a woman living in an isolated village has an eclampsia seizure, her midwife should give her magnesium sulfate, although it is usually risky to give that medicine at home. Then the midwife should take the woman to the hospital immediately, because both the seizure and magnesium sulfate are very dangerous. It can be difficult to decide when to get help.
When you are not sure, get medical help. A book for midwives 2013 finding the underlying causes of health problems 21 finding the underlying causes of health problems as a midwife, you need to find and treat the immediate causes of health problems. For example, think again about the story of Celestina and Elena. The immediate cause of Elena’s tiredness was anemia. If Elena eats more iron-rich foods or maybe takes iron pills, she will probably get better.
Sometimes, you may need to hurry
When we deal with the immediate causes of problems, we can help people feel better or we can save their lives, especially in emergencies. It is very important to address the immediate cause of a problem. But if we only address the immediate cause, we may not really solve the problem. It may reappear or affect other people in the community.
- Diseases are usually caused by a group of causes: direct causes, such as microbes or lack of iron, and less direct and deeper causes that can be social, economic or political. If we discover those causes, we can prevent problems from happening again.
- Elena’s problem, for example, has many root causes. Celestina could probably discover some of those causes on her own. But it would be better if she and Elena met with a group of people in the community to think about the problem, because anemia is not only Elena’s problem, it is a community problem. (Some questions don’t have an easy and quick answer!
May produce a long discussion). Warning! In this book we explain how to do some procedures that can be dangerous if not done correctly; for example, how to do a pelvic exam, How to place an IUD, or how to sew a tear. It is not enough to read about these procedures. Before you do them, first look at how other experienced health workers do them. Then rehearse while an experienced and trained person watches and helps you.
But why did he have anemia?
Only when you have rehearsed this way many times will you be able to safely do these procedures yourself. Because I had anemia. Because I didn’t eat enough iron-rich foods. I didn’t know which foods had iron. I couldn’t buy meat. Because he’s poor. She and her husband are peasants and earn very little money. Why was Elena tired? But why did he have anemia? But why didn’t he eat enough iron-rich foods? But for what other reason? But why couldn’t he buy meat?
But why do peasants earn so little money? A book for midwives 2013 22 Chapter 2: treating health problems once you have asked questions like this for a while, you will find that Elena’s anemia was due to many causes. Exercise also shows why anemia is a problem that affects most women in the village, and not just Elena. Indeed, it is a problem that affects most women in most poor peoples and communities around the world. To prevent more problems, analyze the root causes health problems have many root causes. To discover them, you have to analyze in depth the different aspects of people’s lives that contribute to the problem. For example, a fistula is a terrible complication of some births.
When a birth takes too long, the tissue inside the vagina can be crushed and torn, thus forming a hole connected to the bladder. This causes serious health problems and a constant drip of urine. To avoid fistulas, you simply have to avoid too long births. If a woman is in labor for more than a day, she must be taken to a hospital. But if we take a closer look at the different causes of very long births, we can take more steps to avoid fistulas and other related problems.